After a great deal of thought, I hereby propose a substantial revamp of the U.S. health care system, based on private sector, market-based solutions.
The current tax code encourages home ownership by allowing people to deduct the interest on a mortgage. A similar tax incentive will be created in order to encourage individual purchase of health insurance. (And/or Medical Savings Accounts.) As an individual, you can determine the degree of risk you want to take by choosing different health care coverage and deductible amounts. (Your employer can still pay your insurance premium if it wants to but it will get no more of a tax credit than if it paid, say, your car insurance premium.)
In my plan, all insurance payments will go directly to the individual. Individuals prepay medical institutions or physicians with cash or credit cards and then get reimbursed (if insured). But, because the individual is making the payment, he/she can negotiate fees and charges with the institution beforehand. Just like buying a car. Or having a fender repaired.
Insurance policies will be available across state lines, with offerings from Level 3 basic care to more encompassing programs ending with Level 6: The Gold Standard - an ultra-premium plan. (Levels 1 and 2 are government-aid programs to ensure that no one in America need die on the street in medical agony.) Insurance firms may impose modest and reasonable surcharges on unhealthy individuals (or individuals with unhealthy lifestyles) but cannot deny coverage to any U.S. citizen, including those with pre-existing conditions.
You can move up as many levels as you want by supplementing your insurance coverage with cash. Your own money or, if the medical procedure is beyond your means, with contributions from your friends. Or from your church or social organizations. (It pays to be well-liked and a 'joiner'; angry loners should probably open a Medical Savings Account.)
Medicare remains in place but covers fairly basic medical needs. If a Medicare recipient wants a more elevated standard of care, he/she will have to purchase supplemental private insurance. Or make up the difference with cash.
The concept of various health care levels represents the best of America - freedom of choice combined with 'ya get whatcha pay for' capitalism and rugged individualism. Here are the various care levels, presented with easy-to-understand illustrations ... because we Americans love pictures and comparison tables: