You can only reduce the cost of health care a few ways: (1) rationing or limiting access to expensive care and procedures, (2) improving efficiency in providing care, in billing etc. (3) lowering expenses - i.e. malpractice limitations, (4) price controls / regulating insurance company profits, etc., (5) forcing all people to bear some of the cost to bring market forces to bear.  The rest of the argument/legislation is about who pays for it.  It is essentially an argument between which is better: government control in a single payer type system (the government as insurer), or personal control as administered by insurance companies, or some split between the two.  I believe New Zealand has a split where the government subsidizes doctor visits (4 a year) and provides ER care for accidents.  The individual is responsible for the rest through insurance (I do not know the extent of their Medicaid type programs but it is probably more limited in scope of care than here).