It is a publically accountable system that is best suited to define the boundaries of available resources and guide practice with information pointing to optimal generic treatment strategies. Increasingly, physicians are being penalized for patients with high medical expenses by losing bonuses or even being dropped from plans. CQI is based on the dedication of the managers and continuous involvement of all employees in quality improvement. By freeing health providers from billing distractions, and efforts to shift costs elsewhere, appropriate attention can be directed to making care work better. Single-payer facilitates real health planning , assuring resources are there when they are needed and not duplicated when an excess will diminish quality or inflate costs.
Much managerial energy is devoted to creating demand to fill excess capacity.
Currently redundant surgical suites jeopardize quality when complicated surgeries like heart bypasses are performed too infrequently to maintain proficiency. Quality of care would be better served by regionalizing specialized surgeries and tests.