Good health care, like good government, must be of, by and for the people. All benefit when health for all improves; only healthy nations can remain wealthy ones Health care systems cannot be created or destroyed - only transformed. Wishing a world where human nature is overcome cannot replace enlightened self-interest in the real world. Common interests for patients, providers, business, and government are in the lowest possible stable and predictable cost to keep themselves, their laborers, consumers, citizens, employees, and armies well, employed, productive, and taxpaying.

When everyone pays, everyone benefits. The same base amount out of payroll taxes for the same basic services for those employed; workfare accruing social benefit credits through community service pays for those who have no jobs but can work; and the community or state pays for those unable to be employed or to provide community services. Anyone can buy up out of pocket or by accruing social benefit credit. Everybody gets an ATM-like Medicard to hold their credits, and patients, employers, governments, and others can add value depending upon value received.

A sufficient incentive for government to fully participate and attract private participation in the system would be in decreased cost as instead of having to cover all care for those who need it or not, they could be provider only of last resort, and get out of the business of complex oversight and tinkering with people's lives and behaviors. For instance, the FDA should only be concerned with safety of medications and have a limited time upon which to rule. The marketplace will determine efficacy. Imagine the nightmare if the government were to try to steer people only to nail salons or hairdressers that were effective as well as safe.

Businesses will have cheaper rates for their insurance and insurance providers will rate businesses in the same fashion as bond credit ratings now apply. Those businesses that pony up to bring their patients to a higher level (medium care or maximum care) will have healthier employees and less costs, and can be provided insurance for less. If individuals maintain their health, watch their weight, exercise, participate in prevention, the reward is less out of pocket expenses. It is possible to link healthy neighborhoods, healthy communities, healthy cities, counties, and regions to the wealth of the nation.

The universal benefits schedule would cover the Oregon basics to be modified no more frequently than yearly based on outside evidence, of for example, Cochrane investigation quality. Coverage would apply no matter where you are hurt or took ill, whether at home, at work, on the job, or in a motor vehicle or other accident. There would no longer be factors in who pays for what so the consumer will save and can choose on what and where to spend the savings that remain. Finally, providers would be held more accountable by a more rational construct for what is reasonable care, could still be sued for malice, negligence, and wanton acts, but the loser would pay.

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