This is a big issue now, so let's review just a few things without leaping to any remedies.
The system is flawed, costs are rising out of control and what people get for their money isn't enough. Yes the U.S. is the best country to be treated for cancer in but it's levels of infant mortality and life expectancy rate poorly.
The rising cost of health care must be contained. Now an industry is an industry, is steel production were an ever increasing percent of GDP then it wouldn't be widely considered to be a problem. O.k. to have your economy dependent on any particular sector is unhealthy, but there wouldn't be the widespread concern over steel as there is over health care. Why is health care as a percent of GDP such a concern? Two reasons, the first is that so much of health care is paid for by the government and the government is broke, the second is that people need health care and the rising share of the economy doesn't represent increased access it represents increased costs and these increased costs take away from other things people might buy. The government, or public, part of this isn't the immediate problem because it is either funded directly through taxes or supplemented through debt revenues, these don't create a drain on consumption now. The main problem is private health expenditures, the rising costs of health care is directly translated into higher insurance premiums. So it is the private end of health care which needs the most immediate reform.
We have universal care already. No one goes without health care. You may get your care in a cilinic or you may get it in an emergency room, but everyone gets care. Thinking about it in this light brings to the fore how inefficient the system is. Consider this also, there are two ways of funding health care, private and public, if one compares nations the U.S. pays as much on it's public health system as a perecent of GDP as other nations do who have universal care. The private expenditures come on top of that.
We already ration health care. Health care like anything else is ultimately a finite resource, there is not an unlimited supply of health care. If one wants to extend primary health care to everyone the system will bring in more demand for resources but not increase the resources offhand, so some delays in services would probably result. This is considered rationing, but the type of rationing we practice now is based on access not on the amount of demand. On the first tier are those who can afford excellent plans, on the second tier are those who are eligible for public plans, on the lowest tier are those who have neither. So we do ration, we do limit access to available resources, we just do it on the basis of wealth or the ability to meet certain criteria, this most certainly isn't a very moral system.
The best way to contain health costs is to pull as many healthy people into the system and make them pay for it now while they are healthy, right now the system is too dependent on levying costs on those at risk of needing the system. The more healthy people you pull in the more costs are spread out. But this is a short lived cure, demographics insure that as the surge of baby boomers ages the benefit of healthy paying to sick needing care will never be the only thing that must be done to help contain costs.
The payments government makes into the system create a floor of pricing that must be worked against. If a very large consumer like the government says it will pay x amount of dollars for something there is very little reason for the supplier to find a way to charge less.
Everything must be on the table. Tort reform, lawsuit reform to contain malpractice costs, may only save a smell amount of money in the great scheme of things but it like everything else should be addressed. The system is so flawed that every little bit helps.
To reduce health expenditures should mean reducing employment in one of the few private growth industries in the U.S. The thing about that though is that there will be ever increaing demand for health care. Between the aging of society and the increase of conditions such as autism the need for more people in health care will continue no matter what. So the idea so much should not be to reduce the amount we spend on health care but to spend it much more wisely. This should allow for increased employment in the industry, even if the level of services changes.
And finally we must reform the system. We can do so now while we have choice in the matter or we can wait until the system is so broke that it must be fixed as an emergency measure. The sooner we fix it the more choice we have in what we do and the better chance we have to put savings to use.