We both agree government spending on health care is unsustainable. But as Herb Stein pointed it, "if something cannot go on forever, it will stop," rephrased to the pithier, "Trends that can't continue, won't." (Thank you Wikipedia).
Consumers don't have enough skin in the game. From my perspective, that means if the price of something is set artificially low, consumers will demand more of it than they would in a free market.
You chide me to wanting to eliminate tax deductions for health insurance. Fine. Keep them. But make it portable so people don't get stuck with an employer making that decision.
Those who need help, should get help. I think the corollary we left unsaid is, those who should help themselves, should. Now I think we also agree that's the real problem. There is an enormous middle class entitlement called Medicare, which is an inter-generational wealth transfer and spending on it must come down. Everyone who can add knows this is the problem. Does Paul Ryan want to end Medicare as we know it? You bet. So does Obama. Because both can add and both can see it has to end as we know it.