Scott Gottlieb wrote an interesting piece in the Wall Street Enquirer Journal called "No, You Can't Keep Your Health Plan". In it he argues that buying up doctors practices and putting them on salary is a bad thing. Yet later on he says "Overhead costs already consume more than 60% of the revenue generated by an average medical practice, according to a 2007 survey by the Medical Group Management Association."
The rationalization against making health care delivery more efficient? "Consolidated practices and salaried doctors will leave fewer options for patients and longer waiting times for routine appointments". Of course there is no data to support this.
IMHO Scott believes that patients and doctors should be free to prescribe whatever treatments or procedures they choose regardless if they actually work.
Today the Washington Posts shows what happens when doctors start building their own treatment centers in very cost effective areas: "Increase in health tests, procedures is raising costs in frugal Utah". Turns out that when you buy expensive equipment and suites you use them: "Between 2000 and 2007, Medicare spending in the Provo region rose on average 8.6 percent a year, nearly double the average national rate of 4.7 percent, according to the Dartmouth Atlas of Health Care, which analyzes geographic variations in medical spending. Provo's growth occurred as Medicare beneficiaries underwent surgeries more frequently and spent more of their dying days in intensive care units."
And since employers subsidize the majority of insurance premiums, the WSJ path will lead to increasing costs for businesses and taxpayers. But I guess that's o.k.