Some good points in there, but it leaves out some obvious, well-known facts that don't support the author's general position. Take this paragraph, which is true on a quick glance, but has some serious problems with it:

> It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

That misses three obvious points about the American system: First, healthcare is tax advantaged, which causes even the most standard health issues to go through middlemen. Second, the supply of doctors is kept artificially low with very heavy licensing requirements. Third, the FDA approval process is very lengthy and expensive. Implying that the effect of a bloated, inefficient system is due a cause of free enterprise, private-sector, and for-profit insurance leaves out these well known points. More details:

1. Health insurance is massively tax-advantaged in the United States. Employers and employees pay no taxes on health insurance coverage.

This leads to lots of things. Here's a few: Frequently, all routine medical expenses are routed through health insurance. Antibiotics or a simple doctor's visit - $10 or $50 respectively - aren't paid for out of pocket, but claims are sent in and much paperwork is done. Routine expenses like checkups, physicals, and simple one-off prescriptions aren't what insurance is needed for. Think about if your auto insurance was expanded to cover all your gasoline and oil changes, but only from certain gas stations or mechanics. Then you paid much higher auto insurance, but all your gas and oil was free as long as you met a complicated set of contradictory rules. And then auto insurance was made tax free.

2. The supply of doctors in the United States is artificially limited by ridiculous overboard licensing requirements. This artificially drives up price. A doctor needs to complete undergraduate studies, medical studies, and complete an indentured-servant undermarket brutal residency to get their medical license. Doctors look at 8-10 years (longer for specialists) of training and hundreds of thousands of dollars of bills. Some of the most expensive and in-demand types of medicine are artificially restricted even further: There's only a few schools with programs for them, and they admit limited numbers of people.

Certainly, a doctor needs a high standard of training, but the current system is way overboard. This artificially keeps supply down and makes medicine more expensive.

3. The average cost per approved drug of the FDA approval process is $800 million. This increases the cost of new drugs and therapies tremendously. Drugs aren't tested just for safety - they also have to meet efficacy standards. That means they need to be proven to work - but that means drugs come out sometimes years later at much higher prices than they would otherwise.

The author pointed out that the "free enterprise -- private-sector, for-profit health insurance" system in the United States is expensive and inefficient. Author implies it's because it's a free enterprise, private sector, for-profit system. Maybe there's some truth in that, but it misses how the tax code, medical licensing, and drug approval processes all increase costs. Working to improve just those three areas would dramatically bring down the expense of care.

There's a lot of problems in the system, though I'm inclined to fix obvious ones with simple solutions before embarking on difficult and complicated solutions. Here's a few suggestions that would be easy to implement, reduce costs of American health care, and increase quality:

1. Making all medical and health purchases tax deductible regardless of insurance status would lower the cost of premiums, administration, and would help people who don't have large coverage.

2. Reducing the really lengthy, unflexible, expensive licensing process for doctors would increase the number of doctors in the USA and lower the costs of visiting a GP or specialist. Doctors could probably get sufficiently good at medicine with 4-6 years of education and 1-2 years of on-job training at closer to market rates. Make it easier to open a medical program that can complete the licensing requirements, especially so that more specialists can be trained in the expensive and highly in-demand fields. Artificially keeping the number of cardiologists down, for example, drives up costs for people with heart problems. If any mix of trained educator and cardiologist could open a licensing program easily, you'd see lots more cardiologists and better quality, less expensive heart treatment available.

3. Streamlining and reducing the costs of the approval process would get drugs to people faster, have the drugs become generic faster, and make them cheaper. You could immediately strike the "efficacy" requirement from the FDA, and have them test just for safety. Individual doctors can explain how likely they think a drug is to have positive effects on a patient once it has been proven safe. Requiring the treatment to be shown to be effective (beyond just not harming the patient) makes medicine more expensive and slower to reach people. Medicines that aren't very effective but aren't harmful don't set the world back so much. But people die while waiting for treatments that are already proven safe are going through multiple, rigorous, expensive trials to be proven effective. Once they are proven effective, some people have already passed away whose lives the treatment would've saved with a forward-thinking physician. And it makes the costs of all medicine higher: Reducing FDA requirements would be beneficial on a number of levels. Keep the safety requirements, but reduce "proven to work" to "seems promising that it could work" - especially in cases of a drug treating a fatal condition.