Fixing the American Healthcare System
There's no easy answer to this one. There are three essential problems that make this a major challenge for the nation to tackle. I'll order them from "well, duh" to "borderline conspiracy theory" in political terms to serve as a gentle introduction to these ideas.
First -- and this one should be painfully obvious -- there's a great deal of greed in the system, ranging from individual practitioners and departments to healthcare organizations and insurance companies. Combining for-profit motives with healthcare has now been proven (convincingly) not to work; when a hospital's primary motivation is profit, your health can only come second. This leads to inappropriately early discharges (to free up a bed for a potentially more-profitable patient), excessive testing, hyper-inflated prices for common supplies (eight dollars for an off-brand adhesive bandage, anyone?), and too many different people getting involved than is strictly necessary, introducing more "billers" to the situation.
Insurance companies, motivated solely by profit and with no interest whatsoever in the health of their customers, are in the business of paying less in benefits than the fees they collect for those benefits. This is an automatic, built-in conflict of interest -- your health insurance company is not interested in treating your illnesses and curing your diseases (unless not doing so will make subsequent treatment more expensive and they're unable to cancel your policy -- though they're getting quite good at canceling people's policies now); they're interested in paying for your annual physical (to make sure nothing expensive is getting ready to flare up) and paying for just enough treatments to keep you quiet and paying.
The profit motive, so firmly engrained in the culture of healthcare in the States, is the first major problem that must be tackled. There are alternatives that, like in so many other industries, would better reward the actual practitioners and other healthcare providers (doctors, nurses, office and hospital staff, etc.) and yield better results (healthier people, fewer misdiagnoses, and cheaper overall services). One drastic alternative is to prevent hospitals from being owned or operated by for-profit businesses (and require existing ones to be spun off as non-profits). Naturally hospitals need money to operate, but profits from operations should be directly reinvested into the hospital -- repairs, expansions, improved equipment, raises for personnel (not just at the top), research and outreach efforts.
Another alternative is implementing single-payer healthcare, similar to what was originally incorporated into the so-called "ObamaCare" healthcare reform bill that was subsequently gutted by Congress so it could be passed in any form at all. While the UK's National Health Service is commonly trotted out by opponents as an example of just how bad single-payer systems can get, but counterexamples like Canada's and Australia's Medicare and Taiwan's National Health Insurance clearly demonstrate that it can work very effectively. With a single pool of funds available, regardless of the method of delivery of healthcare, billing fraud, greed, and similar money-wasting problems can largely be headed off. I'm not naive enough to suggest that a government-run fund would be any less susceptible to corruption and laundering than a privately-held one; another non-profit organization (such as a trust, with careful regulation and close, public scrutiny) would be the best option for something like this.
The second problem is related to the first -- hyper-inflated costs for healthcare, along with distorted billing practices and other issues involved in actually collecting payments for services rendered. It's widely understood that in America, a visit to an emergency room (with a real, life-threatening emergency) without health insurance can essentially bankrupt the patient if they're not sitting on a big nest egg (to the tune of $50k or more). Even including the fact that hospitals will commonly reduce a patient's bill by up to 80% when they're paying cash (another symptom of our broken existing health insurance system), health services are bloody expensive today.
Some of this is unavoidable -- doctors study for a long time to earn their credentials, as do nurses and other technicians. Equipment isn't cheap, and building hospitals isn't either. However, healthcare isn't something that's necessarily "optional" -- some people do inflict their own ailments upon themselves (smokers tend to get lung cancer, alcoholics tend to have liver problems, etc.), but many people do not. Problems emerge because our bodies are imperfect, creaky and spongy things that are brittle and bruise easily.
Part of the solution to the hyper-inflation problem is eliminating the first problem I discussed -- the profit motive in healthcare causes hospitals to bill as much as they possibly can, while it also compels insurance providers to pay as little as they can, sometimes to the point of refusing to pay at all (leaving the patient holding the bag with less negotiating power than if he'd just paid cash). The other part of the solution is harder -- convincing society as a whole that healthcare is something we should all contribute to, knowing full well that each of us contributing may not ever get the same dollar amount of benefit back from that system. The reward for willingly contributing to it is that if we do encounter some nasty health problem, we'll know it'll be paid for. In other words, we act cooperatively and pool our resources to create a healthcare system that will treat everyone. Again, this yields a healthier society overall, decreasing costs (because problems can be detected more quickly, treated effectively with no fear of exploding costs causing a bankruptcy, and funding goes where it's needed instead of being funneled through siphoning middlemen).
The third, most "conspiracy theory style" problem I want to bring up is the fact that in many cases, treating a patient's symptoms (with drugs or other therapies) is more lucrative for the supplier or practitioner than actually curing the underlying disease. This is illustrated perfectly by the current patent situation in the US -- drugs are patented as they emerge from the research and trial phases, and even if they effectively treat symptoms impressively, they tend not to actually cure diseases. Patented drugs cannot be made available in generic form, and so the manufacturer is free to set the price for each treatment as high as they wish, going far beyond recouping research & development costs and diving straight into profit territory. This very frequently results in some patients paying $1,000 or more per month for their medication regimen, which is outlandish and simply unacceptable.
Greed is, of course, at the root of this problem too, and the good news is the solution is relatively straightforward. We need more public funding of medical research efforts, instead of leaving it to private corporations to do all the work. This isn't meant to suggest that private corporations don't produce innovative, effective and impressive therapies, but their motive for doing so isn't to see people healed and cured; it's to keep profits rolling in. I disagree with the traditional notion held by the private pharmaceutical and medical industries that profits aren't to be found in actually curing people. There's new people all the time, with new ailments, and there will always be demand for healthcare services even if they always aim for cures versus profits.
Encouraging public funding of medical research yields immediate results: government isn't meant to be a for-profit institution either, so the expected "net gain" from a research effort isn't profit, but practical and effective therapies for varying ailments. If a university research lab produces a cure for HIV/AIDS after five years of hard work and $100 million spent, the benefit should be obvious: a lethal disease that eventually kills all who are infected with no known cure is suddenly curable. Millions of lives could then be saved by a treatment that's made publicly available, inexpensively, as a direct result of public funding. It's true that not all of those saved lives will end up being productive themselves, but the majority will, and the net gain for society in saving millions of its own ranks should be painfully obvious.
To wrap this up, I suppose the best summary is simply this: healthcare is too privatized right now, the companies involved in it are sickeningly greedy, and we waste more money than we spend effectively treating symptoms, curing diseases and researching new therapies. My suggestions can be summarized quickly as well -- yank the profit motive out of the system as much as possible by converting hospitals to non-profits, convert the existing payments system to a single-payer one with a publicly-held trust managing the resource pool, and fund more public medical research at universities and hospitals to get medical progress out of the hands of private businesses that exploit the patent system for more profits instead of acting in the public's best interests.
Sigh ... I know. "Good luck achieving any of this." Nobody ever said the fixes would be easy :)