John C. Goodman: Three Simple Ways Medicare Can Save Money - WSJ.com

This editorial in WSJ in August 2011 had some very good ideas on how the Government could save money on Medicare.  In effect there are many forms of price-fixing going on in the medical community that distorts the free market in very perverse ways.  It even discourages doctors from working in fields where we badly need them to be working.  John C Goodman is the president and CEO of the National Center for Policy Analysis --

John C. Goodman: Three Simple Ways Medicare Can Save Money - WSJ.com:

He recommends allowing Medicare patients to use free-standing emergency care clinics with posted prices, allow them to use commercial telephone and email services (Teledoc), and participate in "concierge doctors" where patients pay a flat fee each year for all types of services.  All of these recommendations sound good as a "sound bite" and may result in some immediate savings -- but I'm not sure that they will save much money in the long haul.

I think these are good starts -- but the "devil's in the details" --Each of these types of medical service could also contribute to additional cost increases, misuse, and fraud, waste and abuse.  For example, if a patient misused the emergency care clinics too frequently, it would bypass the current trips to the emergency rooms of major hospitals, and then cause the hospitals to have fewer patients to spread their fixed costs over.  If patients used the Teledoc-type services, the same thing could happen, and scam teledoc providers could start up and begin billing medicare for phony services.  The concierge services sound good, and doctors will be more than willing to take on the healthy patients, however those with pre-exiting conditions or who encounter a serious injury or disease will be dropped and passed on to the existing system.  Therefore those concierge services will "skim off" the easy money and probably increase the costs for everyone else.