>>The problem, of course, is malpractice suits

Check out the Texas experience: once it reached the point where 85% of physician law suits ended with no payout to the patient and up to 100% of physicians in some specialties could expect to be sued, physicians began abandoning the state, led by those in high-risk specialties, leaving large areas with no obstetricians or neurosurgeons. People who measure cost don't often consider the real costs when you drive the system to fail like that. It took a few years after Proposal 12 was passed (to disincentivise frivolous suing) for more 600 obstetricians who had left Texas to resume practice there, but some never returned and some counties still are under-served compared to what they used to have. The reality is that once physicians are driven out of primarily rural areas it can be very difficult to attract them back, because practice in the big urban areas is easier and more lucrative. Rural US states are well advised to consider that. It isn't just a US thing: parts of the Australian outback offer huge pay and a $500,000 cash bonus after 5 years for physicians who agree to stick around. You can forget about saving money once your system reaches that point.