8. There is no way to change the way that heathcare is financed without changing the way that medicine is practiced.
9. In order to slow the rate of increase of healthcare expenditures, it is necessary to increase efficiency. Efficiency is promoted by focus and degraded by attempts to accommodate multiple competing interests. For example, efficicency and cost effectiveness is impeded by HIPPA compliance. This is not to say that there may not be some independent argument validating HIPPA regulations, but it must be recognized that these regulations breed inefficiency and its associated costs. The more interests that are accommodated in the healthcare system, e.g. cost-effectiveness, access, liability for adverse outcomes, shorter waiting times, availability of imaging studies, the more that efficiency will decline.