The surest way to do that is to get rid of the socialism of health care that comes from having a job or being on a government program like Medicare. It ought to be illegal for employers to offer direct health care benefits to their employees. Under today’s system of health insurance provided as a fringe benefit (an entitlement that many employees take totally for granted), few employees give adequate attention to how much health care they consume or what it really costs.

Let employers pay their employees what the market demands for their services, and let employees go to the marketplace and negotiate for the best health plans. If that results in a one-time increase in paychecks (and an equal offset to the employer’s health insurance costs), so be it. If employees have to spend their own dollars for health care insurance, they will pay much more attention the next time they go to a doctor’s office, or have that lab test, or check into a hospital. And most will start shopping for health care services like they might for a new car.

Likewise, if we must continue to endure the already bankrupt Medicare system, give the same ability to shop around to all Medicare recipients. Stop providing unlimited health care access with little or no responsibility on the part of the beneficiary. Like most other things in life, force retirees (or their children) to make some intelligent choices. Just like employees, force them to go to the market place and negotiate the best plans in the atmosphere of pure competition among service providers. Retirees managed to be smart enough to get to retirement. It wouldn’t take too many conversations with other elders, or articles in their AARP magazine, for them to figure out whether their current plan was the best one for them.

If we took out the free ride inherent in our current health care system for huge portions of our population, they would help us make the system vastly more efficient and effective. We’d see prices for health care decline almost overnight, and we’d see the incredible annual compounding of health care premiums approach the rate of inflation.

The free market mechanism of pure competition based on service levels and price is a great invention. We just need to apply it to our health care system.

I am a practicing physician, work about 70-80 hrs week and prior to this - went to school for 8 yrs, and received 7 yrs of training beyond that. That’s 15 yrs and over $200,000 of debt ($14000 interest/yr)- before I even started working. I would also point out - for many specialities - incomes for phyicians have not kept up with inflation. For example, there are nurses (such as ICU and ER nurses) who routinely make more money than some physicians. This is especially true for some primary care doctors or academics or if you break down salaries by hourly income.

But how about the insurance companies? The CEO of Wellpoint made over 20 million dollars last year. He and his top executives all received increases in base salary for their good work, made huge gains in profitability for the company(they made billions), but still felt it necessary to increase premiums to patients and reduce payments for physicians. The top executives of Wellpoint made well over 70 million dollars - in 2006 alone. And that was just one company.

Point being - the physicians, the patients, the nurses - we are all allies. We want all want good health. For me, it’s my job and my passion. The larger issue we all need to take notice is the “outsiders” who are slowly encroaching and are simply in business to make money off the pateints and the people who provide the care. They want their cut, and that cut is getting larger and larger every day.

Should insurance be paying for Viagra and plastic surgery? No. The system needs revamping. But we do not need socialized medicine or a government program. Government screws things up worse than the private sector ever could. Just my opinion.