Maybe I've missed something, that's possible I've been working very hard lately (I'm a trauma surgeon). Could it be possible that the goals of healthcare reform have changed? I thought the purpose of healthcare reform was twofold -- first, to improve healthcare and secondly, to decrease health care costs. Currently we're spending $2.2 trillion in healthcare per year. Approximately 1/3 of expenses are eaten up by insurance companies. So, if you do the math and a limiting health insurance companies you have approximate $700 billion. This should cover the 46 million Americans who are currently uninsured.

Sen. Kent Conrad (Democrat -- North Dakota) has floated a plan which uses customer health cooperatives or co-ops. These co-ops would operate at the state level or even the regional level. They would be not-for-profit. They would provide coverage for individuals or small businesses (with less than 10 employees). State rules and laws would apply to these plans. There would be "strong governance standards" which should help focus on the customer.

I'm sorry, what the hell is this? How does this improve healthcare one iota? In order to improve healthcare we need to pay primary care providers differently. They should be paid to keep a group of Americans healthy. The medical literature needs to focus on what is the "best" medical practice. Once that practice is decided those physicians who adhere to the "best" practices should be financially rewarded. How do these health co-ops get us any closer to this goal?

Americans spend an overwhelming amount of money (over $280 billion) on pharmaceuticals and medical durable products (bedside commodes, pacemakers, examination tables, syringes,titanium orthopedic rods are just a few of these products). How do we control these costs with the combination of large insurance companies and these small health co-ops? I'm not sure who this post be fooled by this proposal. Lawmakers. The American people. Or both.

The answer to fixing our health care problem is very simple. We need universal healthcare. We need the government to have the ability to negotiate prices. What a government run system be a panacea? No, but with the right legislation, it could be the right solution for all Americans.

From TP:

This morning on MSNBC, former Gov. Howard Dean rejected Conrad's proposal, saying it is "not a real compromise." "This is a fix for the Senate problem," he said, "this doesn't fix the American problem." After heaping praise on Conrad, Dean explained:

He's wrong about this. The co-ops are too small to compete with the big, private insurance companies. They will kill the co-ops completely by undercutting them, using their financial clout to do it. In the small states like mine and like Senator Conrad's, you're never gonna get to the 500,000 number signed up in the co-op that you need to in order for them to have any marketing [power].

This is a compromise designed to deal with problems in the Senate. But it doesn't deal with problems in America. And I think it's time for the Senate to stop playing politics, do what has to be done. ... If the Republicans don't want to get on board, then we can do this without the Republicans.