Okay.  I admit it.  I'm fortunate.  My honorable military service has allowed me access to the Veterans Administration's health care system.  This has relieved me from the problems of searching for effective cost efficient commercial health insurance.  But that's the real problem.  Isn't it ?  Can you find and keep even the minimum health insurance coverages in America without pledging portions of your body (an arm and a leg come to mind) ?  When available through an employer, I have availed myself of those options to supplement the VA's coverage and to reduce my co-pays.  But, honestly, how many employers can really afford to provide these benefits ?  Not many of the small businesses I've worked for.  And any company with fewer than 25 employees is considered business non-grata by insurance companies.  And my employers, indeed most American businesses are in this category.  After all America runs on small businesses.   Even more so with the modern advent of e-sales.  Of course they don't get the favoritism or tax breaks big 'contributing' businesses get.  But they truly are the backbone of America's, and probably the world's, economy.  So the problem becomes how to reduce insurance and health care costs while raising the standards of care.

It should be clear that any potential solution will be as complicated as the problem itself.  Solving it means we must find a way to reduce costs to both insurance companies, and out of pocket costs to the uninsured or underinsured.  And, we must do so utilizing currently funded programs.  To limit the political debates, arguments, and disagreements, as well as repercussions to current and future federal budgets.  Understand, it is not my intention to institute some new government agency.  Historically, any problem the government attempts to solve with a new program usually just ends up creating another level of bureaucracy that poorly addresses the problem - if at all.  A good example is The Affordable Care Act, which from my research is neither.  Additionally, any program with limited sign up or coverage alteration periods creates bigger cracks for the most needy to fall through.  Ultimately, it's not surprising.  These programs are promoted by Democrats then gutted by Republicans. Democrats, typically, are elected on a platform of empowering the poor.  While Republicans are elected on a platform of protecting the rich.  So nothing is accomplished for working middle class Americans.                  

The first step to solving this national crisis is understanding the convoluted system of finance that has been instituted to build and equip each facility.  Research has shown that, government regulations not withstanding, nothing is as screwed up as the hospital chargemaster.  You probably don't know, as I didn't, that each facility has a listing of charges for each item or service rendered to a patient.  Regulations from the Center for Medicare and Medicaid (CMS.gov) state that this listing must be available to the public.  But; that regulation failed to standardize the listing codes.  So each facility has a different internal code for the same or similar services.  Helping the "black hole" of hospital pricing to remain unwieldy and unknown to the layman. Increasing the difficulty of verification by consumers and insurance companies.  Additionally;  the pricing practices follow no legitimate mathmatical basis.  The cost of services rendered can be widely disparate.  Five miles may separate the facilities but the pricing of one may be five times higher than its nearest neighbor - for the same procedures.  We are all aware that health care prices are unnaturally inflated.  Industry lobbyists justify this by refering to the negative adjustments made by the government and insurance providers to reduce their final amount due.  While the uninsured are expected to pay the full amount.  If you can pay it at the time services are rendered.  Then a discount is probable, if negotiated wisely.  Unfortunately most people don't have $5 thousand dollars laying around to give to a hospital.  And, if the balance is sent to a bill collector, late fees and fines are applied.  And often these collectors can be quite loathsome in their collection tactics.  I'm sure their own paycheck is dependent on how much they can collect.  These unreasonable disparaties are at the heart of  this national crises.                  

In any other industry the deceptive pricing practices utilized by these institutions would quickly come under Congressional scrutiny.  How they have been justified, before now, to both consumers and Congress.  Only reinforces the ineptitude, I allready suspected, from this country's former and current leadership. The exposure of the national banking system to such imprudent fiscal practices borders on criminal negligence.  Does your local market apply a 500 percent markup on a pound of hamburger ?  Then negotiate a better deal for cash in hand at the register ?  No.  Any business, expecting to do business, must state the true value of its goods or services.  We as consumers depend on true and just pricing practices to aid us in determining where we take our business.  And health care must be no different.  Therefore; any prices reflected in the facility's chargemaster must, by necessity, be based on sound business economics.  Standardization of the chargemaster throughout the industry allows for this.  And promotes smarter consumers by providing cost reference materials that are directly compareable.  Indeed, through the use of  "in network" service providers, I believe something similar is already in use.  Companies having pre-negotiated cost controls and received  true cost guarantees in return for the business provided by the subscribers to these services.

Next; lets address the 'for profit' nature of insurance companies and health care providers.  As an American I fervently believe in free enterprise.  So the profitability of most of these companies is indisputable.  The profitability of companies providing mandated insurance - by necessity is.  Any, Federally or State, mandated insurance coverages must be accompanied by mandated cost controls.  To prevent corporate abuses for the benefit of stockholders. This is especially true for health insurance.  No CEO can serve two masters.  Either the insured will suffer for the benefit of stockholders or stockholders will suffer for the benefit of the insured.  I suspect that, more often than not, it's the former.  So realize that any options I propose would be available only to non-profit organizations.  That includes both insurance and care providers with few exceptions.  The goal; reducing health costs so that every person or family can afford insurance.  And keep their extremities.                  

To succeed we must address those things that affect health care costs the most.  Starting with the "hard" costs of care; equipment and building charges.  Specifically those related to emergency treatment, operating rooms, or rooms alloted for longer stays.  Before we can hope to reduce costs to anyone, individual or company, we must eliminate those costs that should be subsidized on a national level.  This demands that all hospital and health care financing be underwritten by the nations social welfare and medicare systems.   I'm not suggesting a free-for-all giveaway of government funds.  But 100 year amortization of the amount financed and assumption of liability by this nation's social welfare system. Amortization of equipment financing would be dependent on the expected lifespan and technological applicability.  With the result that the charges for use during patient diagnostics would shift from the individual or insurance provider to the nation as a whole.  Promoting the use of these systems.  And, by unrestricted use, the health of the individuals.  Americans need to be healthy to provide, not just for themselves and their families.   But for the nation's health.  And America has an obligation to promote the fullest measure of care our technology and national conscience can provide.                  

Now to the "soft costs". Those charges incurred through the need for attendant personnel and the consumable or "one time use" items needed for patient treatment.   These are charges that must be borne by the consumer.  Allowing for the promotion of reasonable wages for those persons providing for the welfare and cleanliness not just of the patients but of the facility itself.  From the custodians to the doctors.  Each must be duly compensated to promote their own health and comfort.  As well as affording the opportunity for growth.  Not just in their field but in their family as well.                    
Finally.  Let's discuss the real problem with heatlth care.  And, indeed, every  crises, major or minor, that exists in America today.   Our short-sighted politicians.  This country's leadership can't seem to solve problems past the next election cycle.  Placing their need for re-election  above the nation's need for permanent, long term (100 year minimum) solutions.  The low quality of their capacity is content to leave a legacy that consists only of their name next to their picture.  My belief. Deeds live forever.  And, I ain't pretty.  I want the nation's future children to benefit, not by knowing my name or what I look like.  But by the vision of my deeds.  That a methodology for competent health care was put in place that benefits not just the current generation.  But for generations.