[boapnuaput]

In the USA, at least, there is a singular problem: In the early 70s, the HMO Act and similar legislation was passed, bringing in the HMO-oriented system of healthcare.

A silver bullet would consist of introducing a single-payer system and winding down the HMOs.

[conanbatt]

HMO's are very successful in terms of providing cost/care solutions. The fact that they are so unpopular reveals the american preference: they want to see any doctor, at any time, with as much access as possible.

[Dumblydorr]

Anecdata: A nuclear family member was the president of an HMO for a few years, as far as I know they successfully pooled Medicare resources and made group-wide decisions that saved a lot of money.