Every year the HMOs are increasing premiums by 10 to 15% and at the same time, the quality of health care is getting worse. Both employees as well as the employers are paying increasingly huge amounts. I have the following suggestions: 1. Mandate premium freeze for next 5 years. State is a major payer of premium and can bargain due to its influencing power. 2. Start State operated hospitals that can provide health care to any one. The premium must be decided by State based on the income. This way state can provide more employment, provide health care to every one and can get lot of revenues as well and at the same time can reduce expenses like employees premium, medical payments etc. Any one must be able to walk in to these hospitals to get care for a nominal cost. 3. Import doctors and nurses from other countries to reduce cost.