The German and other European systems achieve lower costs and universal coverage by imposing tight controls on prices for services, drugs and devices. Britain's National Health Service doesn't bother with insurance companies and claims forms -- by eliminating insurance company overhead it achieves much lower costs than even the German system does. Even before Obamacare, federal and state governments, through Medicare, Medicaid and other programs, paid more than 50% of U.S. health care bills. That was more than 9% of GDP, and the amount Britain spends to accomplish universal coverage -- without the additional $4,600 per person American businesses and individuals pony up. Reducing U.S. doctors' fees and drug and device prices down to German levels won't be easy or likely possible, but politicians, providers and businesses still providing health insurance will need a solution -- likely a scapegoat. Enter the insurance companies that have been screwing down doctor's fees, hassling everyone with mindless paperwork and paying executives like royalty. The federal government could probably pay doctors, drug companies and device manufactures pretty reasonably directly, and without the insurance company middlemen, through an American National Health Service. Follow @pmorici1This article was written by an independent contributor, separate from TheStreet's regular news coverage.