John Snow, Treasury Secretary, never realized that he’d be spending so much time on health care, but it’s the elephant in the room of the fiscal future of the United States. Medicare could end up at 20% of GDP of health spending, and that will take all of the US budget if not stopped. Secondly, this hits at competitiveness for US business. And of course wages becoming a smaller part of total compensation.

Health care produces the most new products and probably best doctors in the world. But there;s a breakdown between all of that excellence and all that money and its outcomes. HC is way behind the times, especially in use of IT.

Too many people uncovered, too many small businesses uncovered. Too expensive and rising at too fast a rate.

So the Administration has an agenda, etc, etc. Of course he starts on the junk lawsuits issue, and gets a smattering of applause. He says HSAs are a promise, not a panacea. But he says (after a lot of well known rhetoric about HSAs) that there’ll be 20m Americans in HSAs, and many of those will be previously uninsured.

Most of health $ spent in last months of life and 5 percent of population drive over 50 percent of cost. When will we begin discussing end of life policy?

The idea is to have a refundable $3,000 HSA for that part of the population.

Should employers be in the business of providing health coverage?

It’s an accident that we’re there in the first place (price controls in the war). Best way to organize health care? No, but it’s what we’ve got. We wont get rid of it but the market is leading to major changes.

79% of the audience says that the percentage of health insurance coming from employers will be lower than it is today. And Snow agrees.