The first step is not reforming the healthcare system -- it’s permitting everyone access to it, probably through a single-payer type of insurance.  The healthcare system is satisfactory, but getting everyone access to it is the big problem.  It will not be free, as some people like to state, but will be paid by taxes and should be a single-payer system, like Medicare.  There are many forums where the features of such a single-payer system are described. But the primary reason for it as envisioned today is to achieve universal coverage and to relieve a healthcare provider from having to deal with a myriad of insurance companies to receive payment for services or get permission to treat, etc.  At this point, a federal system, perhaps an expansion of Medicare, seems doable.  If insurance companies were willing to trim their expenses and provide universal coverage for a reasonable rate, they would be welcome to compete for segments of the system.  

Dear Argus:

Only the wealthy have access to adequate healthcare, and as a result we rank near the bottom of the list of 30 industrialized countries in almost every measure of health care quality.   We do, however, top the list in one catagory....cost.

 According to a report done for the Commonwealth Fund, the US spends 13.9 % of its GDP on health care, an average of $5,267 per capita.  The is a 53% higher per capita cost than ANY other country!  if we compare the results (our "bang for the buck"), we might note that Japan (which spends only 7.8% of its GDP on healthcare) is #1 in life expectancy, whereas the US with 13.9% expense is #24.  Simply genetics, you say?  Consider the fact that most Americans are of European origen, and yet almost all European countries beat us in all measures of health care quality at far lower per capita cost, even including their Arab and African minorities.  Maybe geography?  Well, consider Canada.  We spend almost 50% more of our GDP ( and an even higher percentage on a per capita basis) on health care, and yet Canada beats us hands down on national health care quality measures.  Adn, don't bother to tell me anecdotal evidence about "long lines", because statistics show that the average American actually waits longer for almost all procedures except the most "elective" ones, such as face lifts.

 Also, spare me the BS about the importance of "tort reform".  Of the $5,267 per capita dollars spent on  health care in the US, the Commonwealth Fund found that only $16 went to medical malpractice settlements (most to the payment itself, with far less to the legal fee), so the importance of "legal fees' (your #1 suggestion for reducing cost) is clearly insignificant.

And, as for tax deductions, they don't mean a thing to folks who don't make enough to itemize their deductions, which means that most Americans, particularly the poor, would receive no benefit at all.  Of course, such a scheme would give the rich yet another break at the expense of the rest of us.

When I was a kid, I was informed that the "Red Chinese" system would eventually fail because it accepted ideological purity to trump competence and scientific rationality.  Could it be that you have allowed your own "conservative", mean-spirited ideology to blind you to the statistical facts, or is it that you are, in fact, following your leader's instructions to lie over and over in order to "catapault the propaganda" in an effort the promote the agenda of insurance companies and a few fat-cat medical specialist practitioners?

Please, if you are going to comment in an effort to educate others, could you at least back your position with at least some valid data?

<<Tort reform to prevent lawyers from feeding off the system.>>

 It's not the lawyers, it's not the insurance companies, it's the providers!

I don't completely discount what you say, but I'm sick of the finger pointing at the lawyers and malpractice carriers. There's plenty of greed from for-profit hospitals, Pharma,  and the doctors themselves that drives the costs up. Ross Perot, who didn't say much of use, pointed out in '92 that we had a national health plan, and it's a bad one. We have a system now that forces the working poor to wait until they are sick enough to go to the emergency room to get treated, or go into work and do the best acting job they can to get injuries incurred at home covered on work comp.

I agree 100% that health insurance premiums should be tax deductible. I agree that the Feds should look at using their buying power to allow individuals and small businesses to join groups and obtain low-cost coverage. I'll even say I think the Feds ought to reinsure health insurance plans and malpractice plans, and introduce some common-sense tort reform. But mostly, I also believe that firms like HCA (hello, Mr. Frist), and the actions of Big Pharma, need to come under much closer scrutiny and (gasp!) regulation. (Which reminds me, why hasn't our congress lifted re-importation restrictions?).

I also think Republicans ought to be forced to defend their "We want American Health, not European health" comments. It seems to me, taking a cue from the corporate world, that if someone has a better idea, you make the idea your own and use it. It looks to me like Europe has a better plan.

Sorry about this posting as a new comment.  It was supposed to be a reply to Bill Harding who I sent information on sources.  Mea Culpa!