[s_wilwerding]

I don't think you can discount American's sense of entitlement. As everyone here knows, most people have no trouble spending other people's money, and that's essentially how insurance here works (private and public/Medicare/Medicaid). Most people who have either private or public health coverage have absolutely no incentive to save money - if they stub their toe, they go the ER, if they have a health problem, they want every test under the sun.

I'll give an example - I work for Fortune 200 company, who's benefits have always been good. When I first started 10 years ago, you could get the gold-plated family healthcare plan for $300 a month - no deductible, co-pay, etc. The people who bought into the plan would rack up ludicrous bills because they figured they'd paid their money and they ought to get the most out of it. A few years ago, the company switched to Health Savings Accounts and actually gives us money in them each year, and they have come out far ahead because the employees now see the money in those accounts as their money, and they tend to spend it much more wisely. It also helps that the money rolls over, so that money I save on healthcare this year can be used in the future.

If we could only figure out something like that on the national level, we'd really have a plan...