Very true, and very good point. There's no doubt that room will have to be made to improve typical provider contracts.
However, 80% (I think that's the number) of health care costs in the average lifetime occur after age 65, so I don't think better provider contracts in such a system would cost significantly more. Plus, universal preventive and diagnostic coverage would catch many conditions far earlier, bending the cost curve down even more.
Taking this massive monkey off the backs of American business, better preventive/diagnostic services, a strong element of free market competition would be serious positives, though. Another element of this, now that I'm thinking about it, would be tort reform, which would decrease provider costs of doing business via (a) far less "preventive medicine" (doing a million tests to cover your ass) and (b) lower malpractice insurance premiums.
Definitely some bugs to work out, and gross costs might increase somewhat, agreed. But it would be one system that we already know works logistically, vs. 7 that don't even coordinate with each other.
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