As stated, there are five areas here to address, insurance companies, health care providers, lawyers, patients and the government.

1. Health insurance companies must be made to operate like all other insurance companies in America, that is their little kingdoms in each state must be eliminated and they must be allowed to sell across state lines. The free market is great at lowering costs and pooling tens of millions of individuals together instead of hundreds of thousands will do just that. This would also make health insurance portable for the owner of the policy. The other thing that needs to be done is detailed in “THE DEDUCTIBLE SCAM”.
2. Health Care providers must start charging “actual pricing” for their procedures. I have had two broken arms in my life and each time I had them set and eight weeks later came back and had the cast removed. When my daughter broke her arm, we were told to come back in every two weeks to have the cast removed, arm x-rayed and recast. When I informed the hospital staff we would not be doing that they said “fine, but it will still cost you the full $900”. This is when I learned about global charging which is like paying for getting your engine rebuilt every time you go for an oil change. Health Care providers need to stop this practice of charging the area average and start charging for actual costs to them. They must also be made to start posting these prices like every other business. These two free market principles will also do much to lower health care costs.
3. Lawyers, do I even need to say much here. Malpractice insurance and suits are one of the major factors driving health care cost through the roof. Instituting a system by where the loser pays for all the court cost of both parties will do much to reduce fraudulent claims where doctors and hospitals find it much cheaper to just settle than defended themselves against a false claim.
4. Patients need to realize that insurance is not there to pay for every little band-aid or even broken bone in life. Insurance is there to protect you from bankruptcy in the event of a major medical occurrence. If people will adopt this attitude, catastrophic insurance coverage would dramatically come down; be affordable to everyone; and eventually we would not have the issue of pre-existing conditions any longer. Everyone also needs to take more responsibility for remaining healthy as obesity is the number one cause of illnesses in America.
5. Government, where to start? The government does not run a single thing without rampant fraud and cost overruns and letting them assume more control here is disastrous. Implement the laws necessary to open the free market as mentioned above, encourage employers to give their employees money to shop on the new open markets, and allow Health Saving Accounts to be transferable without being taxed and then get out of the way.