Thank you for your extremely thoughtful response. I agree that the system is broken which is why I am devoting so much non-work time to this. And I agree we can find solutions. I currently think we need a totally free system for societal cost saving care - communicable disease, prenatal care and mental health. When we don't provide this care as a society we will spend more later either in multiple sick people (communicable disease), premature infants (prenatal care) and/or crime (mental health.) And I think that we as a society should ethically provide cost effective care free to all individuals who contribute to society or the betterment of themselves (students, workers, volunteers and care providers). I make this distinction because some human beings are in a downward spiral. I strongly believe that doing something constructive is important for everyone( if you pay people to stay in bed, their health starts to decline.) If people choose not to help themselves, many other people will resent paying taxes to pick up the pieces ( although as mentioned some things are stupid not to provide everyone even those who don't want it.) But then there is everyone else and I know that we can't possible give everyone everything they want. Nor is it fair to only allow the super rich to get these "enhanced services" especially since some middle class people who live frugally would rather buy insurance then spend money on other things. But it isn't fair to tax everyone for a level of care that many don't want no matter what or would not want if they or their families have to give up other things. Perhaps the solution is in the tax structure for this extra insurance Right now all this extra insurance is tax deducible by the company and tax free to the employee. There clearly should not be any tax benefit and it might even make sense to tax some insurance and services. . The problem is very much like that of schools. If all the rich take their kids out of public schools than who is left to advocate for good public schools. That said who decides. Should the committee that decides be bound to have only the basic insurance for them and their families. I think I would serve on a committee if I had to abide by the decision for myself. But I don't think it would be fair for me to make my family not have the same opportunities to extra insurance as everyone else. When I have ethical dilemmas I sometimes wish I could set down a group of ordinary citizens, explain all of the implications and see what they decide. So perhaps that is what we need - an advisory group that includes experts but also citizens from other areas to make the decisions on what gets provided and how much we pay for it. Hmm I wonder if that is what the Health care community meetings are about -
http://change.gov/page/s/hcdiscussion