Allowing any American to buy into Medicare would be a much better solution in all respects. (Assuming we fix part D.)

A young American covered by Medicare would look very attractive to an employer, given that they wouldn’t need to pay for insurance. Indeed, even a pay bonus that more than covered the price of Medicare would be a huge cost saving for almost any company.

Well, you sort of killed it with that first part of the list. No meaningful plan will be acceptable to the insurance companies. Even if a proposal came along that would do something for the uninsured, who currently contribute nothing to their profits they’d insist that they ought to get a cut. Remember, they don’t care about the health of Americans, only the health of their profits.

Why should businesses continue to contribute to employee insurance rather than simply increase wages and let the employees handle their own policies?

$40 billion is a LOT of money but it is a relatively minor percentage of the overall US health care costs and may be a modest investment to allow for universal coverage. Meanwhile costs of doing business may decline and improve US productivity and competitiveness.

There are many opporutnity to make Health Care more efficient and hopefully they will be proposed regardless. Even Newt Gingrich and Hillary Clinton teamed up to make one proposal for electronic data management.

…catastrophic care accounts for 20 to 30 percent of healthcare expenses…According to some estimates, premiums would be 10 percent lower than if private plans continued to pay for such care.

So if the government picks up the tab for something that accounts for 20-30% of health care costs, premiums only go down by 10%? That seems fishy.

In addition, $40 billion is a LOT of money, and it’s sure to rise. This proposal will cost well over a half TRILLION dollars over the next decade. To put that into perspective, the entire Apollo program cost an estimated $135 billion in 2006 dollars.

I’m all for finding ways to lower health care costs and make health care available to more people, but how about finding some ways to simply save money first? Requiring people who want health care to get a yearly checkup would do wonders for lowering costs, since treatment is cheaper when a condition is found earlier. Similarly, looking at ways to get malpractice suits under control would also help tremendously. Reducing some of the bureaucracy that health care providers must deal with would probably also go a long way. Rather than just tax and spend, first let’s find ways to reduce costs.

Also my sympathy is not with the Auto Makers but with the larger community of US industries who have to compete against international companies that do not have the direct burden of health care.

What solutions do you recommend for universal health care that would be acceptable to the extremely powerful insurance industry, fiscal conservatives who still dominate the congress, the large number of people skeptical of a government run program, and politicians who have to defend the plan…?

Every suggestion has weaknesses but at some point we do not want the perfect to be the enemy of the good.

I can see why companies who entered into imprudent contracts with their employees are eager to get shed of them. What I can’t see is why other businesses or individuals should be compelled to do that.

Who pays isn’t the only problem with our health care system. There’s probably some overconsumption (I don’t think that’s a determinative factor in our hugely large health care expenses, though). There’s a tremendous supply/delivery problem (we graduate the same number of docs from medical school today that we did 25 years ago).

But, ultimately, I think we come back to the fact that we have the highest cost of health care administration, the highest paid doctors, and the most expensive hospitals in the world by a significant margin.