I just spent two days in Fraser Valley Health Authority at a meeting on medical makeover. The whole issue of payments boils down to two things: what you want to pay for and how you want to get it. The second thing is there is no perfect system. What you have to do is pick the system that gives you the problems you can live with, not the ones you can't live with. Because there isn't going to be a perfect system, and there isn't the Harry Potter spell that's going to make it all work. You have to pick so that you mix and match, so the deficiencies of one system are covered by the advantages of another. To try to legislate one size fits all, it ain't going to work in Nain or Hopedale or Moose Factory. It might work in downtown Toronto and vice versa. So I think you're going to have to look at geography as well.
First, you have to decide what kinds of services you want and then the best payment model to deliver those, and what can you live with as a problem from it.