BD, please forgive what may have seemed like piling on. I accept your premise, I just don't think it would work. You hit on it yourself - bureacracy. Indeed, doesn't it all come down to trust? We can propose and even enact a reasonable solution to a serious problem, but too often greed takes over. Those "in charge" start figuring ways to line their pockets. One would like to think it is not hopeless....we seem to find solutions (often costly ones) no matter who is in charge.

I spent 28 years of my life in the management of sales and administration of employee benefits (including medical insurance) for small to medium size companies. I have seen the pain on all sides of this issue. The employee who can't afford to purchase health insurance -- the employer who can't afford to purchase health insurance for his or her employees (the small employer often pays a part of the cost, but not nearly enough to encourage the employee to participate) -- Young people who think they'll never get sick, thus do not want to "buy into" a plan offered through their employer (this is what is called "selection" in insurance terms - i.e., when only the older/sicker people participate, causing costs to rise dramatically). The frustration of the providers, who truly want to do the right thing for their patients (as well as those who only want to line their own pockets). The involvement of the government through the legislative process, where often well intentioned public servants make stupid laws that just worsen the problem. The insurance companies, who are in business to make a profit (and often could care less about someone with a serious health problem. The Benefit Specialist (insurance agent or broker) who often gets blamed for increasing costs (it's called "kill the messenger") and who sometimes, out of frustration, does not take the time to really care about the people he or she serves (just give me that commission and I'm out of here).

The trick is to find ways to help everyone, while avoiding fraud and deceit from all the parties involved. I'm not saying we shouldn't try -- I just think we must be careful not to create another big, lumbering, costly government bureacracy (we really already have one in the private sector, but it's working better than governement could make it work, simply because of competition). I have definte ideas on the approach I believe we should consider, but I won't bore you (or anyone else reading this) with those kinds of details. Instead, I'll just offer my apoligies for what might have seemed like uncalled for rancor.

Keep thinking good thoughts and stay involved! Cheers!

Jim