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As a recent New York Times investigation revealed, makers of devices like artificial hips mark up their prices double, triple, or even more when they sell to American hospitals as they do when they sell the same devices to European hospitals. The same is true of a hundred other devices and procedures. Why? Because in Europe, Japan, and other places with highly regulated health care, government rules keep the costs low.

It amazes me that these people don't see that it is the payoff that makes the creation and improvement of artificial hips and things far more wondrous than that possible.

These innovations are not happening overseas. The best techniques, treatments, and innovations are a result of the American system, the best medical care the world has ever known.

They might sell hips cheaper in England, but someone else made it possible for them to even have that option. Government care will strive for equilibrium of cost, which will be a combination of medical cost + graft + political payoff....the old Soviet system. When all medical systems go that route, then the government systems of the world will race toward stasis.

A real capitalist system is not the so-called "unfettered capitalism" of liberal horror stories, but is the "reality based capitalism" of a moral people. A reality based capitalist health system will take pre-existing conditions into account and will gravitate toward a solution that provides the most coverage for the most people at the least cost resulting in the best sustainable profit.

So, this will fall back on me. I will get to decide to buy the plan that best fits my economic situation. Or, I can have a government bureaucrat decide they won't spend more money on me and will give me pain pills. Would I rather they decide, or would I rather that I decide? That's simple. I know that I trust myself.

So, my plan will provide some level of money beyond which they will pay for no more medical care that year. The maximum might be a million or 2 million or whatever I choose. Likewise, there were already exchanges available for pre-existing conditions. So far as those who had no health insurance, there were many who chose intentionally not to have it. There were a number who would have liked care but didn't have the money to buy anything expensive, so settled for catastrophic care insurance, those who were unable to free up money for other than basic necessities, and those who are mentally or otherwise incompetent who simply don't think on these things. This last group will not sign up for a government program either.

The group of concern is those who are stuck at an income level that takes care only of basic necessities of life. A reality-based capitalist system realizes there are times when these people will need regular medical care, and times when they will need costly medical care. Charity will minister to some of these.

For that group that