In yesterday's Wall Street Journal, Vanessa Fuhrmans wrote an interesting story about Pitney Bowes's battle with health care costs ("Attacking Rise in Health Costs, Big Company Meets Resistance"). The story documents the large company's efforts to pinpoint the sources of its rising medical expenses (rising hospital prices, too many MRIs and CT scans, shortened doctor's hours, and huge marketing campaigns for drugs like Nexium).

From the article:

What Pitney Bowes learned tells the larger story of why health costs keep rising in America: A dysfunctional market creates few incentives for any of its participants to deliver efficient care. In fact, competition among insurers, health-care providers and producers of drugs and equipment can often lead to higher, not lower prices.

Even a big company with an entire team dedicated to rooting out the source of rising health-care costs has little power to change these dynamics. "We can isolate certain phenomena and try to act on some and advocate policy for others," says Jack Mahoney, the corporate medical director at Pitney Bowes, who oversees its health-care strategy. "But when you come right down to it, even the biggest company out there will tell you they don't have much influence on the market."

And health care is often more costly on a per employee basis for small to mid-sized companies that can't use their size to muscle better prices from the insurance companies. So today I ask, what would you do if you could change the health care system?