More than 40 million Americans do not have health insurance. In 2008, the United States spent a colossal 17 percent of its gross domestic product on health care. America underperforms in the World Health Organization’s health care rankings. We have a major health care problem – the financial burden and personal hardships brought about by our diseased health care system should not be underestimated.

In 2006, the state of Massachusetts endeavored to solve the problem when it implemented a near-universal health care program. The state required almost all residents to obtain health insurance (similar to state laws concerning automobile insurance) and subsidized premiums for residents earning below federal poverty levels.

Now, however, the state is again struggling to make its program work. In the midst of recession, the 2010 Massachusetts state budget currently falls short by $4 billion, due in part to ballooning health care costs.

Gov. Deval Patrick (D) seeks to reform the compensation system for doctors, hospitals and insurance companies to cut costs. The new system would reward doctors for preventing disease rather than for performing more procedures. Patrick aims to lower compensation for health care providers and thereby make universal health care work.

This is just the sort of thing that lawmakers in Congress who hope to implement universal health care nationwide should consider. America must make tough choices to make health care work. The greed of health care companies and the irresponsible attitude that unresolved medical problems pay dividends have effectively made national health care an impossibility. Only by taking a tough stance against an out-of-control health care industry can nationwide care become reality.

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