Very good ideas. However, reform ideas seem to always cover only preventative or planned medical expenses that can easily be subjec to competition: flu shots or a likely uncomplicated childbirth. It is much harder to price-shop an emergency angioplasty, for example, or save money by doing without anesthesia. Worse, health-care costs are regressive. Tax credits or insurance coverage that starts to kick in at 100% when expenses such as copays reach a certain proportion of family income might help. Because if these problems are not solved at when the expenses are incurred, they will be solved basically by bankruptcy.