I have to write this in my blog, because if I talk about it with my liberal friends I'm sure they'll start hating me again....
I have been in the IT world for a few years now, and the one thing I have seen over and over again is that the big bang large release of software just doesn't work very well. If you take 2 years to develop an application, by the time you are done, the problem the application was supposed to solve has completely changed and your solution is useless.
I am thinking that health care reform is going to end up much the same way. Congress/Obama is biting more than they can chew. They are trying to drop in this huge reform bill that will change everything without really knowing how any piece of it will affect the system as a whole.
We need to treat health care like an Agile project. In Agile methodology there is this idea of sprints where basically the whole team picks one issue to address and they all drive towards the goal of fixing that one issue. Once that issue is fixed, you move to the next issue and so on. This methodology leads to getting more useful solutions to the customer in less time.
I think we should use this methodology to fix health care. First, get a set of metrics that actually make sense. For example average insurance costs, number of uninsured people, level of care, etc. Then, implement one small (non-trillion dollar) improvement. Measure again, and repeat. It would be great, we would know what was helping and what was not and we would be able to provide solutions more quickly.