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Here's a proposal: don't allow insurance companies to base their premiums on your age/health status/habits/etc. Make it illegal as if it were a form of discrimination (ie. "The right to health insurance"). That way, their actuarial computations would have to take into account the pool of Americans wanting health insurance. That way, we can truly shop for the lowest premiums. The only differences in cost would be the efficiency of their back-offices. That would surely be cheaper on the whole as compared to the current system (which is cheap until you have to renew your insurance after you've gotten sick). Although the healthier would have to take up some of the slack of the unhealthy. Plus there should be a minimum deductible (say 3000 dollars) so that patient's and doctor's decisions are still coupled to cost. Just add in some incentives for a healthy lifestyle and (haven't figured that out yet), and we're set.