I don't think there's anyone out there that would argue that our health care system isn't "broken." If it were up to me, the first step would be to get to the point where the money we put into the system is equivalent to the money we take out. A lot of that's going to come down to adjusting our expectations for care. Newsweek ran a good article on this a few weeks ago, albeit with a sensationalistic headline - The Case for Killing Granny. From the article:
As a doctor friend of mine puts it, "Americans want the best, they want the latest, and they want it now." We expect doctors to make heroic efforts—especially to save our lives and the lives of our loved ones.I'm not sold on single payer either, as none of the plans I've seen have addressed how we would transition from our current system to single payer. What would happen to all the jobs in the health care industry? You can't destroy a complete sector of the economy overnight.
A shift to a prevention oriented mentality is important as well. Too many people end up in the ER or urgent care facilities because they don't have insurance, and thus can't get simple things such as antibiotics early on - so instead of something costing $200 (doctor's visit and prescription), it ends up costing thousands. Granted, $200 is a lot of money, and I can totally understand why someone would skip this visit. Hell, even with insurance, I'm reluctant to make my $20 doctor's visit copay, and another $20 for a script. This mentality has to change, and getting care early on is probably one of the best ways to impact the system.
I'd also like to see radical change with regards to food. John Mackey (co-counder and CEO of Whole Foods) ends an editorial in the Wall Street Journal highlighting this idea:
This begins with the realization that every American adult is responsible for his or her own health.Yes, food habits are trendy these days, especially with the rise of Michael Pollan, but there's merit to recognizing our industrial food system is not sustainable, and is part of the reason for ridiculous obesity rates.
Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat. We should be able to live largely disease-free lives until we are well into our 90s and even past 100 years of age.
Bottom line is change needs to be made, and small, incremental shifts will not result in true change. At this point, the Democrats are shooting themselves in the foot. With all the hype around health care reform, and the small, incremental changes being suggested, most Americans are not going to see change, and will see this as a failure.