My two cents
Malpractice: The only successful legislature that's going into effect these days are caps on pain and suffering (which do lead to less lawsuits) and Bush is still pushing for caps and limitations on suing trauma/EM/OB docs. Some states are losing their surgeons and OBs from malpractice. Some emergency legislature will come down the line from that.
Pay: Medicare is going to take a hit, which mean pay probably will go down for all specialities that are not strictly cash only (some Derm, Plastics). On the bright side, many docs are getting business-saavy so you won't see as many going bankrupt with their practices.
Single payor system: Won't happen. America is too afraid of becoming 'socialist'.
Ancillary providers: I don't think that they will have more autonomy per se but there will be more of them doing doctor-like work, as corporations have realized they are cheaper and almost as effective as MDs.
Nurses: will continue to be in critical demand. We will probably start importing even more Philipinos and other nurses.
Medical technology: As 15 years ago, we will be using more x-rays/CTs/MRs and lab tests and less clinical diagnoses. All docs will be trained in simple ultrasound (we may even carry them around like stethoscopes) We will probably have programs that take in patient data and come up with differential diagnoses.
Surgery: More laproscopic, more robotic procedures, more telesurgery.
