Relative value system (RVS) establishes the amount a physician will be paid for his service. The state insurance commissioner controls which insurance companies operate in the state and what their rates will be.
The question with Obama care is who sets the rates and values
The things that need improving are: Access, affordability, portability, quality and tort reform, which is not mentioned in HR 3200.
HR 3200 opens Pandora's box. There are no limitations and no way to close the box in the future. It provides for taxpayers paying for abortion on demand. It adds physicians to end of life counseling, which is now covered by ministers, lawyers, and social workers. Thus it gives many people the idea that it promotes euthanasia. Currently, if you are denied treatment you can appeal and often get your treatment approved. Under HR 3200 you have no recourse for appeal.
This bill allows access to checking accounts, medical records and personal history in a government database, open to whoever the government approves is in opposition to HIPAA confidentiality laws. This is reminiscent of Nixon's hate lists or Hilary's attempt to raid the FBI files.
The bill's emphasis is on preventative care. We tried that in the 1980s and 1990s Residencies were reduced or closed with students guided into family practice. The result was family doctor's were trained for what tests and images to order. A tentative diagnosis could be made, the doctor couldn't confirm or treat it. We need both the family doctors out in the trenches and specialists to develop and administer the treatment plan. HR 3200 contains too many ideas not related to medical care and should be defeated. Trying to modify the bill will allow too many of these bad features to escape removal only to become reality.