His concerns were:

• The high cost of defensive medicine due to frivolous lawsuits is not addressed.

• Market reforms, such as allowing the purchase of insurance across state lines and the addition of transparency to the medical marketplace, would lower the cost of healthcare through increased competition but are left out of the bill.

• The perverse incentives built into the Medicaid program are addressed for neither patients nor providers.

• While the bill includes a huge expansion of the Medicaid program, it does nothing to fix the problem patients have seeing specialists, many of whom refuse to schedule adequate visit slots for Medicaid patients because of the insufficient payments for care. Medicaid would continue to pay physicians less than their cost of providing care. The Medicaid patients added to the program by the bill will further worsen the already severe access problem.

• The Medicare Physician Payment formula is broken and has led to many physicians refusing to see Medicare patients. The bill does not provide the needed fix.

• Younger patients would be burdened with the cost of health insurance as a result of the prohibition against preexisting condition exclusions coupled with the mandate to purchase insurance.

• Political payoffs have resulted in some states getting greater subsidies for Medicaid at the expense of other states such as Missouri under the bill.

• Even though physician-owned hospitals have been shown to provide lower cost and more effective care to patients, physicians would be banned from future hospital ownership. This political payoff to the hospital industry will protect them from the competition needed to force down costs and will deny patients the benefits of better and less expensive care.

• The perverse incentive of cost-based reimbursement of some providers, including hospitals, is not addressed.

• Patients are not guaranteed access to their own physicians, as under the bill, insurance companies would continue to be allowed to refuse panel membership to any physician willing to accept a company’s terms. According to a recent poll, this simple reform is supported by over ninety percent of the public.

• The bill contains more regulatory burdens on physicians and will make it harder for them to provide care to patients. Many older physicians would retire early as as a result, frustrated with an already over-regulated medical practice.

• The employer mandates in the bill would strain many businesses, thus putting many workers out of work. This political payoff would enrich insurance companies.

• Insurance companies would continue to enjoy exemption from antitrust law as a result of one senator’s demand, blatantly protecting this special interest group that supported him.

• The costs of Medicaid expansion would eventually become an unfunded mandate, straining the budgets of states such as Missouri, which already has a severe budget problem.

• Increased taxation of makers of medical devices would reduce innovation and increase costs for patients.

I’d be interested in your take on this, Dr Thompson.

Merry Christmas to you also.

”
Senior Dem: Kill the Senate health reform bill and start over By Michael O’Brien – 12/23/09 02:12 PM ET

The Senate’s healthcare bill is fatally flawed, a senior Democrat atop a powerful committee said on Wednesday.

Rep. Louise Slaughter (D-N.Y.), the chairwoman of the House Rules Committee and co-chairwoman of the Congressional Pro-Choice Caucus, said that the Senate’s bill is so flawed that it’s unlikely to be resolved in conference with the bill to have passed the House……..”Supporters of the weak Senate bill say ‘just pass it — any bill is better than no bill,’ ” Slaughter wrote. “I strongly disagree — a conference report is unlikely to sufficiently bridge the gap between these two very different bills.”
“  ”
http://thehill.com/blogs/blog-briefing-room/news/73493-senior-dem-kill-the-healthcare-bill-and-start-over

Abortion and the public option are two of the major irreconcilable differences between the bills.

Of course Obama, (who voted ‘Present’ on both measures and at one point said he didn’t know what was in the House bill http://www.realclearpolitics.com/video/2009/07/21/obama_not_familiar_with_key_provision_in_health_care_bill.html ), says that they are in 95% agreement.

Should be an interesting election year in 2010 as Democrats make the final push to pass a bill to offer for Presidential signature (will he know what’s in in then?)

Congressional recess has not been kind to the Democrats (think back to August) because they have to actually hear from their constituents.