I am watching Michael Moore's "Sicko" for the first time....

All the consultants I know who work privately (either medical or surgical) also work within the public health care system. While I'm sure they exist, I'm not aware of many consultants for whom this is not the case.

While there are certainly cases of unsafe practitioners not being removed early (Jayant Patel being the most notable example), I believe this has much more to do with protective culture than the source of funding.

I hgree with those of you who've mentioned litigation as a significant contributor to US healthcare cost. I have idemnity insurance ($2M) as part of my union membership, along with free legal advice and representation, but I doubt I'll need the former and anticipate that the only use I'll have for the latter would be employment- rather than litigation-related - in twenty years of clinical practice nobody I know (nursing or medical) has been individually sued. I don't mean taken to court, I mean any kind of overture of legal action. Even the threat "I'll sue!" is rare.

This doesn't mean, as someone claimed ages ago on this thread, that patients who've been harmed are unable to sue but the cases I've heard of where patients claimed against the hospital as an entity were settled out of court (always legitimate claims, like the patient with diabetic neuropathy who received significant burns from a hot pack placed directly agaisnt her ankle).