Thanks for the comments, all. I agree with Jeff that lifestyle change (healthier eating and living, in addition to Anonymous's point about preventive care) is the key to changing the health care system from the bottom up. Not sure a sin tax is the answer, but at this point we're overdue for a little creativity!
Also, Anonymous makes a great point about following the money -- which to my eyes leads straight to insurers. Granted, they are taking on the risk and should reap the reward. But they also should use that "reward" to make a better product -- better coverage, better services, better support -- for their members.
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