"In Switzerland, where they spend only 11% of GDP on health care, their out-of-pocket expenses equal about 31% of total spending. The difference between 12% and 31% is huge. Once people begin spending substantial sums from their own pockets, they become willing to shop around. Ordinary market incentives begin to operate. A good bill would have encouraged that."
Economics Nobelist Gary Becker thinks it would have been easy to draft a good health care bill, but what we got is bad. Still, he's optimistic.