"The only rational rethinking of the system is to nationalize it . . . "

Gee Carl - I thought Medicare was set up as a national system.
Are you saying that we didn't nationalize enough?
What exactly would that "enough" be?
Wouldn't your earnest angst over the your bogey-man "Third Reich Genocide" justify my view that you won't be satisfied until every person and organization involved in providing health care or services (and technology) be subjected to income and price controls mandated by the government without any waivers?

I might also add that under the current system, physicians are required to purchase their own malpractice insurance, which in may cases is prohibitively expensive and run by private, for-profit companies. This, the student loans, and the overhead required for running any medical practice, combined with decreasing private insurance payments to physicians, will make no rational person want to go into medicine. This will mean that even the 1% will have to go overseas for treatment!

The only rational rethinking of the system is to nationalize it--and make medical malpractice something like worker's comp. To minimize the "medical mistakes," put in place best-practices checklists. Make taxpayers pay (through a fair tax system) for medical education in exchange for five years of paid medical service in areas/specialties needed.

If this seems too radical, our present system is headed for disaster. The glib right-wing "thinkers" like Newt and their think tanks do not know enough to realize that epidemics do not stop at the gates of gated communities.

The GOP has now become almost genocidal--nobody counts except the top 1% who fund reelections and whose lobbyists do a large amount of the "research" on issues and produce position papers. The victim class isn't simply Jews and Gypsies and homosexuals (as in the Third Reich)--they are anyone deemed undesirable (LGBT people, "illegal" immigrants, long-term unemployed, and the non-affluent elderly. By turning Medicare into a voucher system, they are denying care to those who often need it most and who cannot pay for it after a lifetime of working and playing by the rules. And this will make money for the commercial insurers by denying care and pricing coverage out of people's reach. This is a vast improvement on Hitler's Final Solution, which had vast costs in transport, materiel, and manpower, and did NOT turn a profit.

Medicare drug plan must be able to negotiate with drug manufacturers. How would that help medicare?

Why don't the hand-wringing do-gooder collectivist's who champion these socialist welfare programs such as medicare realize that the solution lies in a tried and true measure of previous tyrannies, i.e. mandatory government enforced (no waivers allowed) price and income controls for all persons and industries involved in providing medical care and services?

(why isn't this an indication that medicaid patients are similarly badly served?)

The best Medicare Fix would be have all of congress aged 65+ only use Medicare in their hometown for insurance, and not private carriers. Congress has to feel what the rest of the country is going through.
In NYC. NY Hospital doctors, increasingly do not accept Medicare as Insurance.
While Sloan Kettering does accept Medicare, Medicare pays a fraction of the cost billed.

Our "unique" medical system is finally reaching its natural end. We either need to look to Europe and choose a universal care system - or we'll end up with just health care for the 1%.

The fixes will not "keep reimbursements reasonably high." I suggest that BL check the codes and the reimbursements before making such statements.

I'm not on Medicaid or -care, but, my family doctor of many years last year told me he was no longer accepting any insurance plans (!)... I was so sorry to have to lose him as a family doctor, as we'd built up a relationship for years.

As more and more doctors stop accepting Medicare, and seniors start an "Occupy" movement, joined by millions of seniors-to-be, maybe congress and the president will realize that the whole US healthcare structure needs to be rethought.

Are there really NO statistics on the drop-out rate of providers resulting from reimbursement cuts? Only anecdotes?

Why do we ask Doctors what they should get paid or if they are paid enough?

Doctors are our poorest citizens. don't cut their pay.

Until you can say who pays when peoples' vouchers run out, you can't convince anyone that vouchers are a viable alternative.

At some point, we all just have to agree that capitalist laws of supply and demand do not work for every issue. What's the limit that you are willing to pay to not die???

How can we put a price tag on health? I think we need to take another look at the Canadian system.

When I was hospitalized recently my cardiologist came to the hosp. to make sure I got the right care; the insurance company, GHI, paid him $35 for that visit which took place on a Saturday. A normal office visit is reimbursed at $45 and sometimes less. How ridiculous is that?

I myself am a mental health provider and the insurance companies pay minimal amounts, ranging from $10 to a maximum of $45 per office visit, which hardly covers the costs of renting an office in Manhattan. I cannot imagine why anyone would go into private practice in the health field.

Trudy is very partisan and obviously comments through a liberal lens. Medicare obviously cannot control costs. Look at costs.