Well, it's practical in that it is easily possible to implement. Whether it's any good is another matter. As you observe, it doesn't meet the stated target. Interestingly, a nationalised healthcare system would have ultimately been far less expensive and would likely have resulted in better outcomes. That means that Obama went out of his way to appease insurance companies.
I wonder how easy it would be to implement, as if it would have been easy, then it probably would only have needed one page of legislation. It is as clear as mud to me what the implementation would look like. I wonder even if they know what it is going to be, maybe it is buried somewhere in fine print at the bottom of page 999?
Practitioners in the private sector charge the rates the bosses decide. Unless you are suggesting the doctors themselves run the hospital, as opposed to administrative pencil-pushers? Because i quite like that idea.
Some practitioners may be happy to line their waiting rooms up with very steady large volumes of Government health insurance customers, charging less, but getting more business. Others who offer more expensive services may elect to contract out, and have customers of more expensive health insurance plans and charge them for the more luxurious and specialist services.
But what if a poor person had an illness that required expensive medicine/surgery to aid?
The poor person applies to Government and a way is worked out for him to get that surgery. Obviously not everyone will be helped. UK is a good example. If someone is beyond a certain terminal stage, they may refuse the surgery. Perhaps the poor person may find some benefactors somewhere, but to keep the health insurance for basic medical care realistic and prices low, there would have to be some ceiling to keep the expenses down. Alternatively the Government insurance could allow people to top up their basic insurance to cover services that are not part of the basic care. The person would then still have to get a quote for the surgery first and submit it for pre-approval before going through with it. Private health insurance plans may have special agreements/contracts with some of the private practitioners.