And here is the way to fix that!

Unless you pay, you won't have a say in the new government plans. Sick? The clerk is not sick. Fill out this form. No, you are not being denied health care service - it's just not available. Go home and wait. We'll call you when it is your turn.

"To fix the cost problem, Medicare in 1992 began using the 'resource based relative value system' (RBRVS), a way of evaluating doctors based on factors such as education, effort and specialized training."

Let me edit: "To [worsen things], Medicare in 1992 began using [price controls], a way of [reducing economic efficiency for political reasons].

Instead of or along with the medical VISA card concept we could have a medical Debit card. It could work something like the flexible spending account that my company currently offers. You get to put tax-free dollars into the account and invest the outstanding balance (with funds similar to a 401K account.)

I agree that if people had to pay directly for their own medical costs, the prices of procedures would drop. I always point to the two good examples of this happening today. Cosmetic surgery and Lasik surgery are both elective treatments. Yet the prices of these procedures has dropped drastically in the last 30 years while the quality has risen significantly at the same time.

If we leave medicine to the free markets ... something between a doctor and their patients, we would have excellent care at affordable prices.

How about throwing wads of cash into educating people about all the crap they eat that is killing them so they don't get sick in the first place?!

And I mean really educating them from the top down. Start with the dietitians and the doctors! People need to start getting educated about all the bullsh** being spewed by registered dietitians and doctors everywhere which, to be fair, is not their fault since this is what they are taught in school. The science is out there very clear and very succinct. I suggest people start acquainting themselves with it especially if you are overweight or have overweight children.

Start with Robb Wolf's Paleo Solution and read Professor Loren Cordain and read Gary Taubes' Good Calories, Bad Calories. The internet is FULL of excellent scientists with nothing to sell you and nothing to gain for themselves or big corporate interests like wheat producers and drug manufacturers that have vested interests in keeping people sick. Google Dr. Stephan Guyenet and Dr. Kurt Harris and start reading the Healthy Skeptic (.org) and Dr. Michael Eades.

Once these changes are made it is amazing how good one feels and one quickly realizes that FOOD IS MEDICINE! And then get mad like the rest of us that we've been fed a ill-advised bill of goods about what constitutes a healthy diet. The first thing that needs to go: the BIG FAT LIE that is the Canadian and American Food Pyramids!

In Israel they have national medicine, and excellent results, for much less expense than in America. In many European nations too.

The free market does fail in some areas; pollution is obviously one.

Medical care may be another. Oddly enough, it is Republicans who want to keep people alive past their expiration dates (remember Terri Schiavo, the special session of the Republican Congress, and Presdient Bush cutting short his vacation (!) to fly back to DC to keep the vegetable "alive"?

Kaiser has it right: It pulls the plug, sooner, arther than later. Not soon enough, but close.

It will interesting to listen to Alkon in 10 years when she hits 55. She will find Kaiser raising her rates hard and fast, every year. Because she will be in a higher risk group every year. And at 55, Alkon will face 10 more years to Medicare, yet a fading writing career (newspapers will be dead by then).

Maybe it will be back to sleeping on cardboard boxes for Alkon, hopefully not in the alley. Or maybe family money will help.

Why not just wipe out Medicare, if free markets are the solution?

"In Israel they have national medicine, and excellent results, for much less expense than in America. In many European nations too."

And this has what to do with us? We are so much larger than israel and european countries as to be noncomparable. We have a nonhomogenous population, a large illegal population, and a very large difference in lifestyles. What works for an ant isn't going to work for an elephant.

OK, I'll feed the troll.

We provide a good amount of Israel's national defense money. If we take that away as you so often advocate, their socialized medicine program goes away.

The socialized medicine programs in England, Canada, and Australia are collapsing, already offer a far worse experience on average than the American system, and are unsustainable absent (once again) American defense spending.

And your understanding of Medicare is blinkered. Medicare is a payment scheme, not a health care provisioning scheme like the NHS in England.

And if we're going to use tax dollars to fund medical care for oldsters, I'd rather that the money go to vouchers to purchase individual health-insurance plans rather than let a government with no incentive to be reasonable be in charge of it.

@mom: it's not the size, it's the principle. Socialism just fails more slowly in a smaller nation. But it still inevitably fails.

No, our funding for military means we pour money into Red states. Get real.

Momo-
Such countries as diverse as Thailand, Great Britian and Israel have nationalized medicine, and the results are always the same: Much lower expenditures, roughly same results.

Frankly, I do not like Obamocare, as it does not either go to free markets nor single payer.

Single payer seems to result in lowest costs--but you have to cut people off the hoses at the expiration date.

The R-Party has built a plank around the sanctity of life, based on some sort of psuedo-religious principles (that benefit the health care industry). That means you keep grandma alive on tubes for two moths, and $200k, then she dies.

We are simply have not advanced to the point of an Israel or Thailand when we can say, "You gotta go; you cost too much to keep alive, your life is crappy anyway, and you already lived your life."

Remember Terri Schiavo and ask yourself how that situation, multiplied by millions of examples every year (usually aged) is going to impact your health care expenses.

We are simply have not advanced to the point of an Israel or Thailand when we can say, "You gotta go; you cost too much to keep alive, your life is crappy anyway, and you already lived your life."

This is a usage of "advanced" I have not previously encountered, and I hope never to see it again.

Our funding of our military also means European countries can go budget on theirs.

If we mothballed a large amount of our foreign bases (especially Europe)-- i.e. they have a local cache of beans and bullets, such as tanks, hummers and ammunition, have about 500-1000 troops to make sure everything is there and in running condition -- then withdrew back to the U.S. and then downsized the military through attrition -- over time we could save millions.

The idea the founders had -- we would have a small professional core of soldiers -- but a limited standing force. We now have a large standing force that aren't combatants -- they are support troops. IIRC -- we now have about 1 shooter for 8+ support troops. That is unsustainable.