In rural areas, there is often a heated debate over economic development that essentially boils down to a choice between industrial jobs and tourism jobs. Both come with advantages and disadvantages, but to pit these two sectors against each other in an either-or discussion is a false dichotomy. My hometown provides a good example of how industry and tourism can coexist.
A debate on immigration policy was held recently in Chicago between a conservative and a libertarian. It was an exercise between light regulation and lighter regulation. Both regimes would enlarge the programs for highly skilled foreigners and temporary workers and tighten the border with Mexico.
That is what our system needs. Not third-party payers who know they can always raise premiums to cover these ridiculous costs so never bother to argue, but engaged (and sometimes enraged) consumers who refuse to be treated like patsies.