Rig-
The insurance companies grab about 27% off the top. Trimming that would be a large cost-reduction measure. Tort reform would help some--though perhaps less than you might think. Government-sponsored medical education would be a huge help, as would freeing the government to negotiate drug prices. A better centralized record-keeping system could be a major cost-saver, and preventing prescribing doctors from making money on needless tests would be another.