My friend Dick,
Just got back from two Christmas parties, so this may not be too cogent.
I do believe in free markets, enlightened capitalism, and that attempts to create a utopian "new man" unaffected by human nature are doomed to failure.
I also believe in the sanctity of the contract, and the rights of workers to organize and bargain. On the other side of that coin, I also believe that owners/management have the right to seek other alternatives, be it new workers if a new contract beneficial to both sides can't be negotiated, and/or the utilization of new technologies and proccesses that improve productivity. Finally, I think that we underestimate the ability of our labor force to adapt to change. Most jobs do not require a high degree of specialization that a worker cannot attain through training. It may be difficult for laborers to relocate, but that is something that many managers have had to contend with numerous times during their careers, and it is not easy for them either.
On the issue of rising health costs, I think that administrative and other bureaucratic costs are much less of a factor than rising life expectancy; the legal environment which makes medical professionals more conservative (ordering more tests, longer hospital stays) and transfers funds to the trial lawyers and the enablers of this mess (who do you think that the lawyers funnel the money to?); and that as long as someone else is paying for the medical services, there is an inherent propensity to consume. In the perfect world, people would not smoke, they would watch their diets, exercise, drink moderately, brush their teeth, and focus on preventive health care. Many in our population, specially those with the least resources, due the opposite and develop cancers, heart problems, diabetis, and other dreadful diseases which are hyper expensive to cure, and equally costly to provide some comfort and dignity until death.
I am not smart enough to provide a solution to the medical cost problem in a free society. But I do know that technological advancements can alleviate the situation. Doctor MacKenzie believed that golf promoted good health. Perhaps Medicare should provide an optional benefit to get people outdoors and active as opposed to drugging them up. Maybe more courses modeled after Wild Horse and Rustic Canyon (interesting, walkable, and affordable) would make for a healthier society and lower medical costs. (Ok, I know I'm reaching!)