This is a complex problem that requires a mixture of changes. Right now over 30% of our health care costs is attributed to "administration costs", aka insurance companies! In countries with universal health care it averages less than 2%.(Should we really have to pay a middle-man for health care?)
    In Japan the government sets the prices that can be charged for medical procedures. They are set so low that you can stay 3 nights in a hospital for less than a night in a motel. We should be doing that to some extent but not so harshly that the doctors have to have vending machines and charge for parking as they must in Japan. (I think perhaps a sliding fee scale, dependent on income, might be the best way to achieve this.) Then make medicare/medicaid a catastrophic care resource and retirement supplemental insurance.
    We also know that fraud is rampant in those systems and lots of tests get done because the providers know they'll be paid by tax dollars. In order to cut down on this, I suggest doctors pay a penalty for tests with negative results. Now there is a 2 tier system I believe would stop this from keeping doctors from not performing necessary tests. First, having them contribute 20% of testing fees into a general medical care fund. Second, make the penalties based on a percentage basis: Testing that produces useful results DIVIDED by tests that yield negative results.
(I'ld have to do further research to give exact percentages so the following are strictly examples!) Say we decide the median acceptable ratio is 17/5. Doctors who hit that figure exactly pay no penalties and receive no refunds. Doctors who have 18-21/5 might get back 20% of the money they paid into the fund, and an additional 5% for every positive test result per 5 negatives up to a maximum of 90% of the aforementioned fees. Doctors with 16-14/5 would PAY an additional 3%, plus an additional 3% for every time the top number goes down one.
    I'm sure there are other measures that would help but these reforms seem the most fair and reasonable to me at this time.