Health care is the allocation of resources to the care of one's health. Resources include time, material and knowledge.
The pricing mechanism helps with the allocation of resources.
Third party-payer healthcare (insurance and socialism) break the pricing mechanism. This is bad because it adversely affects the allocation of resources in health care which adversely affects health.
To restore the pricing mechanism, reform must accomplish two things.
First, reform needs to get people to think of their current health issue in terms of their whole life. If spending a little effort today saves a big problem later; one should spend the little effort now.
The second, and really big trick, is to create a structure in which the patient sees the current negotiation as being the part of the bill that comes from their pocket.
The Medical Savings and Loan attempts to revive the ideal that people who can self-fund their care should self-fund their care. Most people can self-fund their care. Such people are expected to pay out of their savings. If their savings are short, they have easy access to loans that they are expected to repay.
People who understand that they are responsible for their entire health bill are likely to approach each health care expense as a negotiation.
When people have extraordinary expenses, my program actually does something sneaky. The program either writes off old loans or gives the patients a block grant for care.
If a person has had bad health experience, but has done a good job using resources, the Medical Savings and Loan will subsidize current care by either writing off old debts or giving a block grant. In this way, the patinet will be negotiating new expenses with their own money.
The ideal is that the money is always flowing from the patient to the doctor, and that the patient views the money for the current bill coming from their pocket.
There is an exception to every rule. The first exception to the rule comes in the case when a person is unconscious or otherwise incapable of negotiating prices in which case a third party must step in to negotiate prices.
Likewise, charitable care is an exception. In true charitable care, the charity is providing health care with its own resources. A charity seeks to accomplish as much good as possible with its resources.