1. Why not have ONE health care system for all - children, old, poor and the military. The amount of money we will save will be immense

2. Businesses will save money becuase we can do away with Workmans Compensation

3. Create modules of care - so that people can purchase them on an as needed basis - this will also automatically make them aware of the things they needed to do - This is a much better system than trying to 'penalize' Physicians
For Example - Everyone will have a "preventive Module" - include an annual physical exam, labs, mammogram, pap and 12 doctor visits
A Diabetic module - lipid profile, Hbaic every 3 months etc etc
A Heartfailure module
Pediatric module with all the immunizations etc

4. Please DO NOT forget the welfare of the Physicians. Most of them are overworked and sleep deprived. If they loose their 'Peace of mind" the quality of care will suffer. So trying to do things like pay for performance is a very bad idea (this is my opinion - and I am a physician so I do have first hand knowledge about this)

5. The focus of Medicare Utilization Reviews need to change. Focus should be on providing quality care at cost - rather than paying private organizations to 'torture' Phsicians and Hospitals. This is one reason more and more doctors are not willing to accept Medicare.  Remember doctors did not go to medical school and spend half their life time training with a goal of 'hurting our patients"  Somewhere along the line this has got forgotten by large administrations like Medicare.