Does that mean you support the waivers or oppose them? I mean the if the bill is a sham then the waivers are good, but the waivers were given by the administration, which is also a sham, so the waivers are no good. Your really confused here aren't you?

Providing access is an important indicator of quality, surely you will agree. If you want additional cost savings you can pass another (more socialist!) bill in addition. Stuff like allowing Medicare to negotiate drug prices and establishing a nation-wide pool come 2014 would seem to fit right in. But i'm not sure why the current law needs to be scrapped, indeed that will just make the situation worse.

http://mydd.com/users/bruce-webb/posts/triggers-medical-loss-ratios-and-sec-116

People who have been complaining since the Tri-Committee Bill and Senate HELP that there were and are no cost controls simply never read the bill. They exist in the form of the MLR provisions, which in the bill that passed into law were set at the 85/80 level. If implemented effectively, and early signs are that the insurance companies weren't able to game MLR in the way they wanted too, this is an excellent and elegant way to prevent the insurers from cheating even in the absence of a public option.

But you need to know how to read and think. People who want to make an honest attempt at actually engaging the bill that was written and not the fantasy one 'explained' by the fantasists that thought HR 676 (the so-called Medicare for All Bill) was actually a seriously intended piece of legislation can start with this diary from Fall 2009, based on an actual reading of what was in the House Bill 3200 Sec 116.

If you don't understand MLR you don't understand anything about how this bill was actually designed to work by original lead authors Kennedy and Dingell. How the lefter end of the left blogosphere managed to convince themselves that those two guys simply sold them out to the insurance companies after a combined 100 years of trying to get universal health care through is beyond me. Ya think you might have given these guys a little more credit and asked WHERE the cost controls were and instead of just accepting the word of a guy at PNHP that they didn't exist? 

They do. In a battle that got fought under the radar the MLR provisions were dropped from the SFC version and only partially restored in either Reid or Pelosi's final version only to be fully restored at the last minute. Which is why AHIP, who had been supporting the bill right through the Fall suddenly started squealing. THEY fully understood the importance of the MLR provisions even if BB doesn't.

There are plenty of English speaking primary care physicians in this world, countries like India and the Philipines pump them out at whatever rate one might like. The problem is the barriers to entrance maintained by the AMA and the various certifying boards that have an interest in rationing access to the profession. Break that artificial barrier and let the labor market for MDs operate fully and that access issue goes away.

The other issues Buckeye raises are important but pale in relation to the monopolies controlled by professional societies not just in medicine but in areas like law