Regardless of your position on this issue, if you think there's a "simple" solution to this problem, you're mistaken. In fact, there isn't a solution at all. There are only trade offs = any change that might "improve" the system in one area is certain to worsen it somewhere else. And, it's quite likely that we won't even agree whether some change is actually an improvement or not.
Let's take the issue of private insurance companies as an example. Private insurance companies make a profit -- as they should, they are private companies. An argument that has been made above is that we should get rid of private insurance companies to decrease the cost of healthcare. Theoretically, this is true -- if we got rid of private insurance companies and (for example) moved everyone to Medicare, health care costs would apparently go down -- we would save any money "lost" to profits, and (in general) it appears Medicare might have lower admin costs than private companies (although that is debatable). On the surface, seems like a win.
But:
1. All of those people working for the insurance companies? Their salaries are paid by those companies. All of those people lose their jobs. Sure, they might get a job in a bigger Medicare, but chances are Medicare will pay less than those private companies. All of those people will be suffering.
2. My hospital, which is relatively efficient, either just barely breaks even on Medicare, or loses money. All of our profit margin (which we use to improve care, buy new technology, etc) comes from the private market. Take that away and we are screwed -- either we will need to increase prices (at which point you lose your cost savings), or downsize / cut salaries (more pain for employees), etc.
3. If we only had one insurance company (Medicare), they could dictate prices and coverage. Would this new treatment that costs $2 million for kids with a genetic illness be covered? Would Medicare just say "We're paying you $100 for it, take it or leave it?" Who would make those decisions? The party in power which changes every few years?
There's no question that we have the most expensive health care system in the world. It's unsustainable -- if we don't change something, the system will fail. Anyone who blames the costs on one group of people -- insurance companies, hospital executive salaries, physician salaries, pharma, gov't regulations, nursing unions, etc -- is missing the point. It's none of those people's fault. It's all of our fault. Perhaps "fault" isn't the right word -- this wasn't really planned, it's developed over the years due to multiple decisions over many years. Change will be really hard because someone will lose. The best solution will probably make everyone unhappy.
Everyone likes talking about cutting "waste", since that seems to hurt no one. But all waste is someone's income. Someone always gets hurt.
