>>Yes but the problem with our bottomless tort system, as I'm sure you know, is that there is no incentive to not litigate any negative medical outcome and we are churning out more lawyers than we are doctors. The insurance reforms are not going do to anything to correct this.

But who will you sue? Just as insurers must match coverage and exclusions to size of premium, facilities will need to declare the level of care they can provide for the sorts of payment available from Medicare. Obviously facilities will go broke if they try to provide today's level of care without reimbursement so if Courts or legislators try to enforce it, the result will be exactly as predicted by Ayn Rand. Meanwhile if society really does decide to make physicians de-facto executioners and then sues them for it, many physicians will quit with regret and will gravitate to other pursuits that society obviously regards as more useful, such as currency trading or derivatives.