Here's my plan for improving healthcare for the Poor.

1) The government provides health insurance for everyone who can't afford private health insurance. These people pay insurance premiums that cover operating costs but no profits. The government utilizes its tremendous market power to force down prices and rationalize costs.

A comprehensive IT solution system will make the whole system "paperless" and ensure that no cheating occurs, that each patient's medical records are accessible for everyone, that everyone gets fast and speedy service, and that costs are held in line.

Measurement of all aspects of the healthcare process provides the best possible way to identify distortions and inefficiencies.

Also, the contents of this IT solution are to be made public (with certain information such as names and SSNs redacted out) in order to provide incentives for independent whistleblowers to ferret out waste.

2) The government does not provide complete healthcare coverage to everyone. Instead, the government hedges out risk by requiring that certain discretionary high-risk activities (like smoking or gross non-genetic obesity, in addition to skydiving) be either compensated for in surcharges or disposed of. People who do high risk things get certain elements of their coverage chopped away and certain amounts of their premiums rebated to them. A smoker may smoke and indeed he will have the amount of his premium that would be used to cover his lung cancer treatment rebated to him since he is no longer covered for that ailment.

3) This pricing plan would make the Government insurance plan acceptable to those who help themselves. The National insurance plan is thus easily phased in to the current population with few adjustment costs. People who present high discretionary risk simply aren't covered initially. As more children are born and enroll in the plan, the insurance plan offers incentives to start early with healthy habits, lowering long-term health care costs.