Kaiser or any large health plan that has their own
2. powerful electronic medical records
3. own hospitals
4. own physicians
is probably the best system for the average consumer. It is the best system for cost effective medicine. High percentage of patients will get the standard of care.
This is the closest place to practice academic medicine without being in an academic center.
the Rich, a cash system on top of health insurance works best
the Poor, even with cheap health plans, or Medicaid will always have to wait and will be subject to unsupervised medicine.
The Seniors with sponsored medicare will be placed in the private health plans shortly to mimic System 1
Solo practice will be getting more and more challenging as the bulk of the population gets roped into system 1.
For all the med students and residents, it is best to truly understand how you get paid as a attending and where the money comes from. It can change your life dramatically when you start looking for a job.
I trained at an academic center, I had NO clue about the business of medicine before finishing. Their motto was residency was for learning medicine only. Which sort of sucks when you graduate, there will be tons of business folks, other doctors willing and wanting to take advantage of you.
If I was smarter before coming out to private practice I would have went another direction with my career.