Re the Medicare annual "wellness" visit - how much do you suppose is the set fee paid to the physician for this service?

>>With these shamans determining what is "necessary" there is no conceivable funding mechanism that would work.

LOL. I hear the same wherever I go- except for different reasons. Example: the NHS (that was rated top in the latest credible comparison of health systems) underwent reforms to introduce the efficiencies of competition in 2012 and now faces a funding crisis. Consider this physician's recipe for resolution: http://www.spectator.co.uk/features/9343402/how-to-fix-the-nhs/ ... and then check out the comments including the preference for the French model! FWIW I'm also guilty of comparing the French system favorably with others, though it faces its own set of problems. The issue is that healthcare is capable of consuming the entire GDP if allowed and much admin boils down to disguising the necessary rationing as something the punters will accept. Those who can afford it need not accept rationing, but there's a very famous reference to the patriarch Zock who funded a Wing of the House of God and perceived Samuel Shem's ejection of wailing relatives and masterly inactivity as a lifesaving innovation. If you wonder what the heck I'm talking about, do read the House of God whose truths from the 1970s demonstrate that the more things change, the more they stay the same. ;-)