I am a physician who is in semiretirement and has advocated returning health care to the simple service transaction between only the patient and the physician. I firmly believe adding third-party into the simple relationship is bureaucratic, intrusive, profit-raking, problematic, and degrading the care at higher cost at the same time.

Non-profit regional self-insurance pools (or cooperatives) to provide catastrophic insurance coverage are the way for lowering the insurance premiums. The pools can provide the plans itself and/or enlist the insurance companies who want to offer plans at reasonable premiums. Because the individual members and businesses control the pools, the pools are self-sufficient and keep the government out.

In pairing with the catastrophic coverage, use Health Savings Accounts (HSAs) for individuals and families to save up money with either tax credits or tax deduction to pay for the first-dollar expense up to the limit of deductible when the catastrophic coverage kicks in. Paying for services with the individual's HSA preserves his decision-making power and motivate his consciousness about both the cost and quality of care. There are designs for establishing HSAs for both Medicare and Medicaid beneficiaries, which will save money for the programs without dictatorial reduction of services Medicare and Medicaid HSAs will save the government from filing bankruptcy..

For my personal story, please visit Autonomous Care at http://autonomouscare.blogspot.com. For the detail of Autonomous Care please visit www.autonomouscare.info.

Robert Su, M.D.