I was thinking about what we really should do for health care, and it occurred to me that it's really even a larger problem. Health care is definitely the biggest single manifestation of this issue, but at the bottom the problem is manipulative binding contracts, exclusionary pricing that forces you into contracts, closed networks, and collusive oligopolies. These same issues are afflicting people in bank accounts, cell phone contracts, cable networks, etc.
The real solution is to find a way to force all of these things to open up to consumer choice. The big problem with health care really is : consumers have no realistic choice options - all health insurances are basically the same ; consumers have no access to information to choose doctors based on prior performance or based on cost ; doctors have no ability to charge different amounts and are not rewarded for charging less or doing less ; specialists are rewarded heavily for doing unnecessary work ; consumers can never make a cost/benefit choice to opt out of care for the elderly or very ill ; consumers can't change plans or opt out of plans because of the collusionary pricing that forces you to have health insurance and not pay cash ; etc. etc.
Basically there is no capitalist competitive market at work in health care at all. Doctors/hospitals are not motivated to do better cheaper more efficient service to attract more clients. Health insurance is not motivated to charge rates that are competitive with cash rack rates because that option does not exist. Health insurance is not really "insurance" at all for most people, but rather just a huge fee that you have to pay simply to be allowed to get care.
With all of these things - bank accounts, cell phones, credit cards, health care, cable networks - I'd like to see a few major overhauls. 1) legal requirement to provide reasonable cash "rack rates". That is, consumer should be able to choose not to sign a binding contract for services, and instead just pay-per-use at a reasonable rate. 2) networks should be required to be opened to other companies at reasonable rates; eg. credit card point of sale networks, ATM's, cable wires, health care providers, etc. should all be required to allow third party companies access. 3) requirement to provide quick clear reports of past performance and disclosure of billing and furthermore notificiation of billing. For example, cell phones and banks should have to disclose how much the average consumer actually pays for bills; eg. when they advertise "$29 a month" cell phone contract, but without including all kinds of surcharges and fees and extra charges, they should be required to disclose "average consumer actually pays $63 a month". Also, when an unexpected bill arises they should be required to notify you *immediately* and even get permission, not just send you a bill months later. eg. if you make some roaming call they should have to say "this will cost $1 do you want to proceed?" not just send you a bill for $1000 at the end of the month. Similarly banks with overdraft, health care with out-of-network anaesthesiologists, etc. There's absolutely no reason not to provide warning these days with computerized everything and automatic email & SMS warnings.
You can't have working capitalism without informed consumers, and you can't have working capitalism without consumers being free to change services. Currently all of these industries are completely broken and are doing nothing but intentionally suckering people into contracts where they pay outrageous fees with very little ability to avoid it or get better treatment.
Really I'd like to avoid a lot of federal regulation, what I'd love to see is for it just to open up to competition, but in some cases the best option may be regulation. For example with cell networks, I think a good argument could be made for just nationalizing the networks and making them open at auction rates to 3rd party service providers. Another option would be to make it illegal to tie a phone to a given network, which would allow consumers to change provider at any time, which would make network bandwidth and quality a commodity and greatly improve the market.
Many of these services have also basically become "utilities" that a human must have to function decently in this society. You can't really choose not to have a bank account or health insurance or a cell phone, and that argues for the government providing them, or mandating some basic availability by law. For example cell providers could be required to provide a $10/month text & voice only contract for the poor.
Banks in particular make me angry because even without the recent TARP disaster, they get massive amounts of public support through the free money from the Fed and the insurance from the FDIC. I think it's perfectly reasonable to have very high requirements on any bank that takes Fed money. For example, they should be required to provide a very basic checking account with zero fees, and most importantly no line or credit or overdraft account, which are extremely predatory practices forced on the poor (and no NSF fees either up to 3 bounces or something; and of course automated warnings).
But of course we'll never see any of that, because the government *wants* corporations to rape consumers, and doesn't actually want to see better competition that will improve services.