HMO's will spend their last dollar to stop introduction of a Single Payer System, and Americans don't like the idea much in any case. But I think there may be a way to create a system that everyone could work with, that would cut costs, improve quality, and leave no one uninsured. It's called the EBay solution.
The essential problem with the system here is that the consumer is not the payer most of the time; the employer is, or the Government. And on top of that most employers only have 2-3 plans to choose from. This is a recipe for high cost and low service. Each HMO is not actually competing with more than one other HMO. And the healthcare consumer has very little choice. No wonder we get high cost and low service. I think we should institute a National Pool. It would be entirely voluntary for any employer, any HMO, any provider, hospital, doctor, etc. It would basically work like EBay. So the deal is to let every employee in the country choose any HMO to be their insurer. Billing would be done electronically by the providers (doctors, etc). Because there would be no paperwork, the cost of healthcare would fall by 30-50%. Competition between a huge pool of HMO's would then cut costs further, which would allow the uninsured to either afford it because it would now be possible for small employers to provide it, and the Government could then bring the Medicare, Medicaid folks into the process. With all those small companies signing up and all those consumers, the HMO's would just have to join to follow their customers. The ultimate step would then be to bring pharmacies into the equation and allow them to bid on an online formulary that would advertise the best price for prescription drugs that could be picked up or mailed to the recipient. In effect, the Government would create a system rather like Nasdaq for health. The problem is not too much capitalism in healthcare; it's too little. Make competition work for the consumers, not against them. I gaurantee you this: build it and they will come. No force needed. Capitalism is very seductive like that. Who wants to go back to regulated, expensive air travel? How about re-regulating the phone companies? I didn't think so. It's the same deal with health.