"Next, really do something about Healthcare premiums in America. It is terrible that the richest country it the world has such high healthcare costs."

To do that, I think you have to attack health care costs. The premiums are (notwithstanding profit margins in the private insurance industry) as high as health care costs demand them to be. Unnecessary testing. People getting things done because "insurance will pay for it" and an number of other issues are in play. I do think something has to be done to drive coverage rates up and costs down, but how to do both simultaneously . . .

And does reduction of the profit motive in health care kill off the obvious innovation that has come from the system here?

Does this mean that primary care and some theoretical "other level" ought to be separate entities?

We'e seen both sides of this in the last couple of years. My older son had a major heart issue and he actually had sudden cardiac arrest twice in a short period. The second time, I was unable to revive him with CPR and thought he'd died in my hands. (Paramedics came through, though). In the aftermath of that, I was both delighted that we have insurance but also was appalled by the cost of what ended up being an ICD implant. Without insurance, it may have bankrupted us. But without the profit motive in our system, would ICD's even have been developed? Doubtful, I think.

The story has a reasonably happy ending. He's made a recovery using a beta blocker and is even playing a pretty high level of baseball again. Was a mid-level college prospect before and that may not be the case now (we'll see next spring), but he's back to playing and having some success. The whole process hasn't been as negative as you might think. He's grown tremendously and is a more responsible and mature young man (of nearly 17) now. The whole ordeal has taken a toll on my health as I'm seeing some fo the aging effects of carrying a really high stress level for a year or more.