Follow the money is correct. Aside from CPT coding that is the basis for all medical billing, government or private, current government medical programs already make up a significant portion of revenue for physicians, hospitals and other medical companies. Medicare makes up between 30-45% of many operations' revenue depending on their geography and demographic. Medicaid is a very close runner up sometimes as high as 25-30% (most companies try to hold that down as it is often a loss leader). This is only going to grow, even without national health care, as the population ages and child birth decreases.

Current estimations have 50% of the population over the age of 50 within the next two decades meaning that a significant portion of citizens will already be using government health care and insurance programs. The initial attempt by the government to privatize Medicare has backfired. Many insurance companies have either had to dump their Medicare policies or significantly reduce coverage of services based on decreasing income and policies that require more management and services for fewer dollars.

Worse, contracting with Medicare means that insurance companies must adhere to certain policies that originated to insure there was no discrimination in services provided to the elderly as opposed to those provided to private health insurance policy holders. This policy boils down to insurance companies having to set their reimbursement based on Medicare's fees. Physicians and other health care providers had to accept this pricing scheme in order to contract with the insurance companies and government health care programs. Under the guise of non-discrimination, handing over health care pricing to the government.

So, while everyone is pointing fingers at insurance companies and health care providers for the rising cost of health care, they ask the government to step in and fix it. Effectively asking the fox to guard the hen house.

Those pricing schemes are based on a national average, with small adjustments by region. High or low, this effectively limited health care providers' and insurance companies' bargaining abilities. They end up lobbying congress over Medicare fees because they know in the long run it will effect private reimbursement. Because government adjustments are usually incremental or result in decreases, that usually means that health care providers and insurance companies lobby for higher incremental prices across a wide variety of services, even if their cost has not significantly increased, in order to make up any short falls in other services where they are losing money.

Further, in regards to covered services, this contracting requirement usually has insurance companies basing their coverage of procedures, equipment and services on government policies and guidelines. If Medicare has not approved of a procedure or has limited the utilization based on diagnosis, that is what the insurance companies are going to cover. Why can't a patient get certain drugs, procedures or services based on their physician's recommendation?

Ask the government. Then look forward to more of the same when they control all of health care. The price won't go down, the coverage won't get better. It will likely be worse.