1) It isn't that I am eager for the changes Mr. Obama has proposed (what are they again? Does anyone know? Does he?) so much as it is that there is very little about the current health care system that I find defensible. I understand that the Republicans do not want government-run health care (except, you know, when they do) but I am equally perplexed as to exactly what it is that Republicans are defending as I am about what the administration is proposing.
2) I think universal health care is a perfectly laudable goal. There really is no reason we couldn't do it (from a financial standpoint) if we weren't so keen on running a global empire. That said, I have absolutely no faith in the American political system to create and run a Canadian or French-style single-payer system (setting aside for the moment whether I would actually want it to or not). There are too many stakeholders in the status quo...we'd have to have public (only) campaign financing first. And that isn't going to happen.
3) That said, if the goal is actually universal care, then I don't understand why the discussion isn't focused on a substantial (and universally available, if not universally utilized) safety net-type system, built from the ground-up in addition to everything that already exists. (And no, I have no idea how to do this.)
This "public option" which is apparently meant to compete with private insurance and drive their prices down while (simultaneously!) not in any way affecting their ability to do business with the millions of people perfectly happy with their current coverage (like, for example, me)--all while the federal government is going to prohibit private insurers from denying anyone coverage for much of anything--is a bunch of incoherent nonsense. Might as well promise a pony to every little girl in America, while we're at it. (It'd be cheaper.)
4) I do worry about the effect of any reform--including the ones I am very vaguely proposing--on health care innovation in the long run. And you should, too, even if you find the notion of charging people money for life-saving care morally reprehensible.
5) If you think Americans spend a lot more on end-of-life care than the rest of the world now, just wait until the Boomers really start dying off. And if you think that they are going to be the ones to change this, I have an ocean-view condo to sell you. It's in Detroit.