Macro trends in possible healthcare legislation?

Mark Frisse shares his thoughts about some possible macro trends in healthcare legislation  and I agree that these are needed and likely.  I especially believe there needs to be more dialog and a closer link between payer intermediaries and decisions at the point of care.  Too many layers and being too far removed increases the risk of undesirable outcomes.

The trends:

1. A shift from plan exclusion of pre-existing illness to controlling expenditures of covered members
2. Rising health care costs
3. More dialog between payer intermediaries and decisions at the point of care
4. More capitation and risk relationships with providers
5. More dynamic provider networks based on a variant of social networks and preferences
6. A shift in the delivery of health care services from physician-based practices to networks of clinicians with varying skills practicing in a wider range of accessible settings
7. A shift in "ROI" from short-term return to long-term value
8. A shifting responsibility from intermediaries to individuals
9. Administrative simplification
10. Pricing and quality transparency