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As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

I would welcome processes that eliminate the need for doctors. We bottle-neck things around doctors, and it's not a good way of doing things.

Many of us are alarmed at the skyrocketing cost of medical care, including patients, who are the consumers. However, medical malpractice is not the reason for these increasing costs.

It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it.

Physicians today, as human beings, are not exempt from the perverse economic pressures created by fee-for-service regimes to see more patients for shorter appointments and order more tests and procedures. If the incentives were changed to pay to foster better health outcomes, I am convinced physician behavior would change over time.

Here's where the insurance companies really fail us. They over-pay hospitals, specialists and drug companies and then raise premiums to cover the costs. Further, when they pay hospitals 115% of what it should cost to care for a patient, they are paying for inefficiency that can be dangerous.

Funding that is focused on the ability to diagnose diseases precisely will just have inestimable value because that's the gate through which precision medicine has to go. Unless you can diagnose the disease precisely, care has to remain in the hands of expensive institutions and expensive caregivers.

Money has transformed every watchdog, every independent authority. Medical doctors are increasingly gulled by the lobbying of pharmaceutical salesmen.

In health care today, we spend most of the dollars - in terms of treating disease - in the last two years of a person's life.