"Innovations have to lead to higher costs, smiley."

In other fields innovation leads to lowered costs.

Complex issue and I'm not firmly in favor of a completely public system, just remembering the Pfizer Welfare Act also known as the Prescription drug Benefit. Warren Buffett and Jack Welsh could come up with a superior system written on the back of a bar napkin in about five minutes, but Congress and its thousands of lobbyists are likely to screw it up.