I've had occasion lately to study the Japanese healthcare system, which is not without its problems, but which manages to stay afloat by negotiating reasonable fees with insurers and health care providers -- which is something we haven't done well in this country. As long as a colonoscopy costs $5,000 for a one-hour procedure, we're not going to solve the problems. If the govt. could partner with private industry to provide basic healthcare at a price that rewarded providers without enriching middlemen, reform might have a chance.