Ideas to Reduce Medical Costs

Here's a brainstorm of ideas to reduce medical costs, one of our country's worse problems.  From my professional experience, the way to solve a complex problem is to take steps, one at a time, to fix what is known to be wrong or inappropriate.  Eventually the problem is solved with many baby steps.  Here goes:

• Tort reform to reduce "defensive" medicine which means the practice of  medicine so that it can survive courtroom cross-examination and outside audit.  The idea is to reduce the cost of excessive tests and procedures.
• Prices are too high because everyone in the medical industry;  doctors, hospitals and patients feel that they are using other people's money.  Therefore, expand and promote medical savings plans so that people and businesses buy high deductible "disaster" insurance at much lower premiums.  In this way when a medical cost comes, the consumer pays, questions the bill, seeks lower price quotes, etc.   The consumer in this way pays more of his/her own money and "has skin in the game."   
• Increase the supply of both doctors and nurses--increased supply means lower prices (salaries) everytime!   
• Break the monopoly of doctor's from the AMA--allow more doctors to practice.  Bring in foreign doctors--allow immigration of medical doctors and nurses.
• Vastly expand physician's assistants to reduce cost.
• Allow pharmacists to prescribe most drugs--they are highly qualified to do so.  This is the way it is in countries with low cost medicine.  No need to go to the doctor for most medicines.  Break the doctor's monopoly!  You yourself generally know what you need especially with a little help from a pharmacist.
• Adopt world-wide drug price bidding to include low cost suppliers from Thailand, India and elsewhere.  Break the monopoly of the major US drug manufacturers!  May the lowest cost provider prevail!
• Allow insurance policies across state lines for increased competition by insurance companies.  May the lowest cost provider prevail!
• Insurance policies across state lines are then "portable."  A policy in Texas should be available in Idaho (and maybe at lower cost).
• Use email and internet to communicate with doctors and allow doctors to send prescriptions to pharmacists (where required).  New types of Medical clinics could hold online chat (chat, video chat or Skype video calls) with medical professionals and clients rather than "old fashioned" office visits.  Doctor's can compete with each other in offering this sort of online service.  Patients can pay a small "visitation" fee with a credit or debit card (online).   Doctor's from India could participate!  Now that would be different!  
• Online doctor clinics could be a good answer for low cost medicine.
• There should be incentives for good health practices.   This means discounts for people with excellent health practices, ie., low insurance rates for people with perfect weight and exercise programs.  Interviews should inquire about diet, drinking, smoking, exercise habits.  Conversely, there should be penalties for fat and sedentary lifestyles.  This would be difficult to accomplish, but nobody has ever asked me how many times per week that I exercise.  I think it's relevant.
• Cost effective performance by doctors and hospitals must be encouraged by insurance companies.