currently hot

And yet another placeholder.

It seems likely that change to something quite as massive as health care is best done incrementally. I do understand that politics may make that approach difficult (at best).

I think the fundamental "hot spots" are these:
* the uninsured
* exclusions on pre-existing conditions
* affordability

One thing that does seem clear is that the American over-reliance on employer-provided health (a legacy of 1950s tax policy) is a mistake and effort needs to go into moving us away from that model. In fact, if our system involved direct personal/individual coverage that began at an early age and was non-cancellable, it would moot concerns about exempting pre-existing conditions. And this would also eliminate concerns about dependents getting kicked off their parent's coverage at a certain age.

Other obvious improvements: limitations on purchasing health insurance across state lines must be destroyed.

Also, virtually all mandated benefits should be eliminated; people can have catastrophic coverage only if they choose. If I understand insurance correctly (which is likely in my case), the real risk is the catastrophic risk with changes to the "deductible" being more a question of simply collecting enough extra to pay for the administrative and "minor" costs of handling additional slightly larger claims. For instance, dental insurance is pretty much a sham - relatively low annual benefit limits with relatively small deductibles means the coverage basically serves a budgeting function of spreading out the costs evenly throughout the year.

Also to be considered: Is everyone 'entitled' to the best possible medical care; do we all get to go to the Mayo Clinic? If the answer is 'no', then the situation is a lot like the joke (sex for $1 mil? | yes | sex for $10? | think a whore!? | established; setting price); one's 'right' to care is limited and it's only a question of where to set the limits knowing that logically 0% care is as valid as 99.9999% care.