Decentralization, assuming it doesn't come with a bundle of regulatory strings attached, may allow a lot more ideas and methods to be developed to handle issues out where the issues actually are.

You don't get much innovation from a huge government bureaucracy (or a huge private one, come to that). In fact, such bureaucracies often work to stifle change and adaptation.

The sooner we get market forces back into the medical system, the sooner costs will start to come down. There is a solid connection between heavily subsidizing a product or service and the price of that service. We see this in medical care, and we're seeing it in higher education, too. This is the origin of the legendary "ten dollar aspirin." You can get that much for an aspirin only if a third party is picking up most of the freight. The billing and payment for medical care has become a Kafkaesque nightmare, with sky high theoretical prices "negotiated" down by insurance companies who then pay most of the remainder. Meanwhile, our population bitches because they have to spend anything at all on medical care, even trivial co-payments.

Look at this paper. I just pulled it up on a random search. Look at Figure One, and look at that elbow. Remember at what point our government began massive subsidies of medical care? For what age group, primarily? And what did those lines on the graph do?

This is not the only place I've seen a graph like this. There was one in an old "Consumer Reports" magazine that unfortunately never put the article online.