The federal government should set policies and get out of the way. The older system to health insurance prior to 1976 and HMOs worked well – third party payers must be eliminated. We should be able to buy health insurance much like car and home insurance – clear descriptions of covered items and costs. Cross state purchasing, etc. are great ideas, but the States should take the lead on managing these issues. I believe it is a Tenth Amendment issue. The federal government is too prone to crony lobbying and special interest groups working against patients’ interests.