Absolutely agree - the best way to lower the cost is to make each customer take out his or her checkbook and pay the doctor. Insurance, and the distance it puts between the consumer and the provider, is probably THE biggest cause of high costs. When the consumer feels as if the care is "free," then there is no consumer pressure to contain cost.
Second, illegal aliens are a separate issue. True, they're forcing the closing of emergency rooms and other emergency services, but health care costs would be high anyway.
Agree on this as well. Between the cost to the public and the consumer to cover "uninsured," and the cost to each consumer for his own procedures that are not "necessary," I suspect that the cost of "unnecessary" services (including tort liability) represents the bigger share of the total health care expenditure.
Third. Tort reform would reduce costs by a fair amount but it would reduce medical care to a bigger crap-shot than presently. There are an awful lot of greedy and incompetent doctors out there - as well as greedy and incompetent lawyers.
I'm not sure tort reform is the answer here. Patients should have the right to sue the pants off incompetent and negligent health care providers. How we, as a society, decide what constitutes "incompetent" and/or "negligent" may be an issue, but the threat of tort liability does put pressure on the health-care industry to police its own. Maybe the answer here is also away from insurance, so that the individual practitioner risks his or her own future in the event of malpractice, instead of passing the buck off to a malpractice insurer.
It's extremely doubtful that any of the above will come to pass. People will never see it as fair that you should get only what you can pay for on this fundamental, life-and-death ue nor will we be willing to militarize the border and deport the millions of illegals. Doing so would require a full-fledged war with Mexico - and maybe several other countries as well.
But if the cost inflation is not due to treating illegal/uninsured, but rather in treating the rest of us, then even getting rid of the illegal/uninsured will not solve the health-care cost problem.