I don't want to blame the government for all problems. This problem is caused by a combination of greed, managerial incompetence, and most importantly, a lack of market forces.

For example: A person goes to the hospital, has whatever done that needs to be done, and then gets a bill. There is no haggling, no comparison shopping. The poor sucker has absolutely no idea of a cost in advance.

My idea for re-introducing market forces goes like this:

1. All medical service providers, druggists, etc, must publish a complete list of charges for all items, along with an average list of charges for certain conditions. This list must be posted prominently in every patient waiting room, etc. Charge schedules may not be changed more often than once per month.

2. All insurance plans will require an increasing co-pay arrangement to make the patients cost-conscious. For example: If a doctor's visit costs $100, the patient will have a co-pay of $10, if it costs $200, the co-pay will be $20, etc. The same with medication. This will provide an incentive for the patient to price-shop for services and supplies. A certain maximum total annual co-pay will be in force.

3. All HMO's, health insurers, and so forth will be required to pay 90% of all revenues on claims or put into reserves for paying claims. This is very important. Some plans use up to 45% of revenues on advertising and another 15% on executive salaries. I want to limit the amount that can be spent on other activities than paying claims to 10% of all revenues, including revenues from interest or investments, etc.

4. No medical insurance policy shall base premiums on the age or medical condition of the applicant. This will spread out the costs of medical care throughout the population, preventing unaffordable premiums those persons who need it most.

5. In order to guarantee that nobody will just wait until ill to apply for insurance, medical insurance will be required of all persons. They can shop around for the best deal, but they need some insurance which adheres to certain standards. Payroll deductions will be sent to the insurer of choice. After all, it is illegal (in most places) to operate a car without insurance.

6. Those who can not pay the full cost of premiums will have their premiums supplemented by payments out of the general revenue.