In the comments of this post, Wally asks:
If you were given a free hand to reform the health care system in the US, what would you do with it? What would be the philosophical goals (if any) of the system?
What follows is my short answer. I will elaborate on them more in future posts.
1. Eliminate the tax advantage employers have over individuals for health insurance (either give the same advantage to individuals or remove it from employers).
2. Modify the emergency care act to encourage responsibility. A couple of ideas include putting a limit on the freebies that can be received and having the expectation that something will be paid somehow.
3. Allow for experimentation and choice. If someone living in New York wants to buy an insurance policy that meets Idaho’s state mandates, let them. Btw, before Obamacare, Idaho’s insurance plans were dirt cheap compared to New York’s. Nobody seemed all that interested in understanding why.
4. Convert as much of medical care as possible to first-party payments. This can be done with health savings accounts and medical stamps for the poor. See Singapore.
Update: In the comments, Mark Rossow reminded me of some excellent pieces by economist John Cochrane on health care.
Also, I elaborated on #1 in this post from 2009, Fix Pre Existing Condition, which explains how I think the tax advantage for employers provided insurance contributed to the oft cited problem of pre-existing conditions. Cochrane agrees.