The HMO system allows insurance companies to focus on profit, at the expense of both medical wisdom and patient welfare. As a person who believes all human lives must be protected, I find these arrangements intolerable. My administration will redesign healthcare, according to these principles:

• Real medical choice (of doctor and treatment) must be available to all people
• Patients must control finance, and have a personal stake in efficiency
• Cost, quality, access to care and patient choice are equally important
• Public oversight is needed to protect the healthcare consumer

In the meantime, here are a few of the many obstacles which must be overcome:

• employers must offer employees the full spectrum of health insurance alternatives (not just identical HMOs) and full information about costs and benefits.
• people covered under COBRA must be offered the same group rates they enjoyed before they lost their jobs.
• People on welfare should be offered our MSA/Catastrophic plan. Pilot studies by the RAND corporation show that better health care can be delivered more cheaply to welfare clients using MSAs than traditional welfare mechanisms.
• College students should be eligible for coverage under their parents policies until age 23.
• The insurance commissioner must establish a minimum proportion of health insurance income (say 80%) to be devoted to actual patient care, exclusive of marketing and administrative overhead. There should be an oversight board, controlled by physicians and patients, to fine-tune needed regulations.
• All insurance policies, public or private, should cover catastrophic illness, so no one can be bankrupted by medical expenses.