An article in the Review section by Elizabeth Rosenthal of The New York Times points to the challenges and potential fixes to providing affordable care to all Americans. Some 80 percent of all health care expenditures are used for just 10 percent of the people and much of that is during the last weeks of life or in treating chronic illness. And then there are ridiculous stories of hospitals bilking patients for little stuff like five hundred dollars a stitch or a hundred thousand dollars for antivenin for a snake bite. Obama-care is a start and a frustrating one at that. For instance, we could cap fees for certain procedures or reduce medical school tuition by requiring service but all these initiatives take political will and as we all know, change is not easy. We could pay more for preventative care and less for traditional care. The ideas are available. The more we educate ourselves, the better. Many counties pay much less than Americans due for better care!