As I see it, taking a broad view of things, there are two basic problems in this country when it comes to healthcare.
#1. We have no real mechanism for caring for the sick. The insurance industry does not exist to take care of sick people. It exists to assist the healthy. It only makes sense--the insurance model works only as long as people are paying in more than the company pays out. But we've come to depend on insurance not only to help us out when we get sick, but also to cover all the other health-related expenses. Chronic illness is not a profitable model for an insurance company.
#2. The cost of routine and preventative care has gotten so exorbitant that it's outside the range of many people's budgets. Routine and preventative car for your car, for example is much cheaper. We need to find a way to make routine and preventative care affordable.
I'm more and more convinced that insurance isn't the solution for anything beyond catastrophic care. The insurance companies aren't really effective for us (or profitable for them--unless they routinely deny care to those who need it) for anything else.
I've also been thinking about this whole diefication of the free market. One of the things that frustrates me about conservatives (on this board and beyond) is their seeming belief in the goodness of the free market, and their unwillingness to acknowledge that no system is perfect, and that capitalism has some pretty serious flaws of its own. The biggest flaw as I see it is the very thing that makes it so effective--it harnesses human ambition (some might say human greed). The thing is just because it works doesn't mean its inherently good. Capitalism does not, for example, have anything to do with the teachings of say, Jesus Christ (apologies to non-Christians here). His teachings are about what we should be. The free market deals with the way we ARE.
It is vital to acknowledge the limits and moral dangers of the free market, because I believe there is an ethical and an unethical way to engage in business. There's nothing wrong with trying to make a profit--there is something wrong with taking that effort to maximize profits to the point where you are hurting the people you are supposed to be providing a service to and/or the people who work for you. There are always ways to cut costs and maximize profits but not all of those ways are right. It seems much of the modern business world does not see such a distinction--increased profit by itself is the ultimate and only good. And many conservatives ape this thinking without fully considering its ramifications.
We have decided as a society that education is something that should not be limited to those who can afford it. We've taken it outside of the free market arena (with varying degrees of success, I admit. After government-run programs have their own set of problems, also having to do with human nature). I think it may be time to do the same with health care.
And if education could be a model, perhaps we might find a solution. You have public schools, you have private schools for-profit, and private schools that are non-profits. My feeling is that the worst of the three is the for-profit school. These schools can often end up sacrificing what is best for the students for what will maximize the bottom line. Our school was a non-profit, and of course we had to be competitive, to stay in business--we needed to bring in more students, and provide topnotch education, but that was for the purpose of keeping our doors open and serving our students, not for the purpose of enriching stockholders.
Could we have a health care system with public, private for-profit, and private non-profit options?