Another idea: make it illegal for anybody but the patient to pay for their healthcare. Insurance pays the patient, who then pays the hospital. If the patient doesn't like the service, or feels they're getting ripped off? They probably won't pay as much.
Bush or Clinton, I forgot who basically was pushing that. Create high deductible plans, add tax benefits attached to them (tax sheltered health saving accounts) so that people are more directly involved in shopping for prices and it was being sold as that would drive the prices and competition to get better.
Yeah, I think the HSA was one of G W Bush's best accomplishments (and, probably, one of the only net-positive accomplishments other than helping in Africa somewhat), which is why I'm sad the new health reforms are basically incompatible with the HSA concept.
As I see it, there are basically two separate ways to make healthcare work -- expose consumers to prices AND give them the tools to make decisions (with subsidies, etc. if we want to let poor people consume more health care than other things, as a matter of policy; I don't think that's an economic argument), or have an external entity with the correct incentives acting on the consumer's behalf. Medicare seems to mostly work on the latter model.
It's clearly possible to screw up both ways, but an even surer way to screw up is to do neither/both-partially.
Ending employer deduction for healthcare (and/or making it deductible for individuals) would be a huge step, too (in either model). I see no actual upside to employers paying for health care vs. individuals or the state at all.
so much for... let's see... expensive treatments like heart transplants, free enterprise, risk sharing... impecunious family member/relative/unrelated S.O. needs expensive treatment and let's see how fast opinions change on that.
Not letting me spend my post-tax money how I see fit (which might include paying for an open source developer who makes a tool I love's inherently expensive medical care) is bad, too.
And stuff like charities to help certain classes of people (poor kids who would benefit from a $300-5000 operation once, like Watsi, seems like a better use of charity money than an 80 year old guy living one extra day) seem like absolute good, too.
There are a few insurance companies like this. However, the patient must have the cash flow for these large expenses. It often takes takes time to get reimbursed.
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