I've just spent 18 months battling a rare strain of thyroid cancer. I have great insurance and pay dearly for it.  (2nd largest cost for us behind the mortgage). My out of pocket costs have been minimal. The docs think it may have been due to radiation exposure as a child.  (You could get your feet X-Rayed at the shoe stores when I was a kid) I'm glad we can afford it. For those who can't, we want the government to bail us out. OK. Here's 2 of my 4 part outline on how to make it happen.

First, Kill the lawyers

You can't fix health care without reforming tort/liability/malpractice laws! Every other daytime TV commercial is for some lawsuit against pharmaceutical company or exposure to some toxin. You want cheap health care, then the patient has to assume some risk. Every time somebody doesn't survive a risky procedure, the family wants to sue. 

My orthopedic surgeon used to volunteer at the county hospital.  Some idiot on a motorcycle crashed - three times the legal limit for alcohol + street drugs. Jim spent 9 hours and several lbs of titanium just patching up this asshole so he might be able to walk again.  Two years later, the same idiot crashed his bike again, drunk again. He sued the surgeon claiming he had lost mobility in his hands. The malpractice insurance paid the dickwad six figures because that would be cheaper than going to court.  Jim's premium's went way up. Result, Jim no longer works for free on the "poor" people.

Every malady for every patient has to go through every fucking test -- just in case we missed something. How much is wasted there? Once a doctor accepts you as a patient, he/she accepts liability for your care. (Try to find an OB/GYN if you are pregnant and over 40!) If the patient fails to mention a history of IV drug use or weekly bouts of sex with $20 hookers, too bad. The doctor is still responsible for keeping him/her alive.

Are you a military veteran with a major back problem? Sure we'll fix you for free -- after we get done with all the active duty cases.  Got stage 1 cancer, wait until it's stage 4 and you are almost dead, we'll move you to the top of the list. Yeah there are greedy docs, insurance companies and suppliers.  How about calling off the legal sharks? Some times the doc's call it wrong.  You want it cheap, you'll need to accept some risk. At least put some kind of ceiling on liability. Or make "free" care subject only to binding arbitration.

Second, Kill the Paper

There are literally hundreds of recording formats, software packages, forms, rules and regulations out there now. Who's going to standardize those? Who's going to store them? Secure them?  Probably a 35% of the cost of care is paperwork and cover your ass memos.  By all means let's look to the U.S. Government to write standards for databases, information exchange, and paperwork reduction. IRS tax codes should be a good model.  At this point, I'd bet no more than 1 out of 5 doctors even use email to talk with their patients.  I don't blame them, somebody will sue under HIPPA because a computer got hacked.

Here's a great opportunity for government to employ thousands in standardizing and cataloging this information. (After all, Al Gore invented the INTERNET)  Oh, wait, those people would actually need to know how to do the work. More training programs! Who will train them?  Those damn greedy corporations who actually have done this kind of thing?

Face it, entitlements get politicians elected. Paying the bill is the next guy's problem.

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