Cosmos' host Carl Sagan expresses astronomical proportions in mere "billions and billions." A trillion is a thousand billions, and we express our national debt in trillions. The government assumes that it must throw money at a problem to solve it.

Unlike the government, businesses cannot levy taxes or borrow limitless funds. Business managers and engineers know that changing the system can yield cost-free improvements in quality and productivity. The system includes procedures for doing the job, and incentives for behavior. Congress' acrimonious and fruitless health care deliberations overlooked several cost-free opportunities to improve the system. Instead of arguing over who was going to pick up the tab, Congress should have taken the free lunch.
 

Rudyard Kipling identified the basic problem in "Dane-Geld." The Danish Vikings would invade a country and demand tribute ("geld," or money). The Vikings knew that they would lose if the country decided to fight. However, they also knew that it was cheaper for the country to pay the tribute. This is how a frivolous lawsuit works. The plaintiff offers a settlement that costs less than the defendant's projected legal fees and lost work time. The existing system rewards misuse of the civil justice system to extort settlements from blameless defendants.

What is the solution?  Rudyard Kipling concluded, "We never pay anyone Dane-Geld."  Robert Goodloe Harper (1798) said, "Millions for defense, but not one cent for tribute." These responses are not easy for a small business, or for a professional whose time is money. States must enact laws that allow juries to award damages to the defendant for frivolous lawsuits. To avoid inhibiting people with genuine grievances from filing suits, the plaintiff should not pay for merely losing the case. The plaintiff should pay only if the jury finds bad faith. If the plaintiff relied on his or her lawyer's advice, there may be an argument for making the lawyer pay. Tort reform's cost to the taxpayer is zero.
 

Some states are suing the tobacco companies for the costs of treating Medicaid patients for tobacco-induced illnesses. Federal and state governments should not hesitate to tax the tobacco companies for the full cost of the damage they cause.
 

The MSA would be a special savings account under the patient's control. People could fund MSAs with pretax dollars, like IRAs or tax-deferred savings plans. Employers could contribute to employee MSAs instead of buying health insurance. Employer-paid health insurance is already a tax-deductible business expense. Employer-funded MSAs would cost taxpayers nothing. MSAs would be fully portable. Employees who lost or left their jobs would keep their MSAs.

People could withdraw money from MSAs to pay for health care, and to buy high-  deductible catastrophic illness policies. High-deductible policies are very cheap, because most insurance claims are small or moderate. (If you have comprehensive and collision auto insurance, look at how the deductible affects your premium.) People would insure themselves (through MSAs) for preventive health care and minor illnesses. High-deductible policies would cover them for major ones. Since the MSA cuts the middleman out of most health care transactions, the overall cost is lower.