The AMA is a problem. That is why accreditation should be done by state agencies, not by private organizations. There is no good reason why a private group, one that is little more than a white collar trade union, should be allowed to control the keys to the industrial kingdom.

There's no way to reduce salaries by fiat unless we nationalize healthcare; reducing salaries organically requires a drop in demand, a rise in supply, or both.

MikeT:

The problem with creating new schools is accreditation. The AMA has had an explicit strategy of “fewer, better doctors” for more than a century.

Medical malpractice is a thorny issue. I'm skeptical about the political effectiveness of pursuing that direction as an approach to solving the problems with our health care system since I think that we'll have problems enough with doctors, hospitals, insurance companies, and patients with the reforms that need to be made without taking on plaintiff's attorneys as well.

1) Provide comprehensive protection from litigation for doctors that do not act negligently against malpractice suits. While we're at it, perhaps most of the malpractice issues should be brought out of the civil system and be brought into the criminal system if they're "that bad." I'll defer to a lawyer on that one, for a change.

2) Provide tax incentives to people who give donations for the creation of new medical schools and the maintenance of existing ones.

3) Encourage every state to create a medical school at every major state university that doesn't already have one, while providing funding to increase the class and staff size of existing ones by 25%.

4) Allow drug companies to pay for their own product evaluations done to FDA standards, provided that the entire process of the certification is done according to FDA standards, is recorded for posterity and the results are submitted for permanent record to either a national medical archive maintained at the Library of Congress or freely available on the Internet.

Increase the number of doctors, nurses, and health techs. Allow the simple tasks to be performed by nurses and health techs. Promote competition and free market solutions. Educate the health care consumers. There are many more small steps that need to be taken to move toward less costly care.

The figures that I've seen are between 20% and 30%. Assuming something other than a best case scenario, here were my assumptions.

Current costs of insurance 20%
Cost of single-payer -10%
Net savings 10%

I don't see that as "fear-mongering". I see it as a realistic projection.

indeed, this is widely reported as the main reason that American health care spending is so much higher than every other first world nation.

I'm sorry, Andy, but that is just not arithmetically possible. Our costs aren't just 30% higher than other OECD countries—they're three times what other OECD countries are paying. You can't get a 70% reduction out of 10% or 20% savings.

BTW, I'm a reasonable interlocutor. There's no need to insult me or belittle me to make your point.

Single-payer might reduce health care costs, perhaps, 10%. That would be more than absorbed by the increases in demand being proposed not to mention the secular increases in health care costs.

This is a combination of fear mongering and lack of facts that is beneath you.

Administrative costs for Medicare and other "universal" systems are on the order of 5-10% of overall costs. Administrative costs for HMO care delivery are 30-40%. So, just looking at paperwork, we're talking about a huge savings -- indeed, this is widely reported as the main reason that American health care spending is so much higher than every other first world nation.

If private care advocates are so sure of the superiority of HMOs and the like, why don't they support opening Medicare to all, without making it mandatory, and allowing competition for the consumers?