I know it is politically incorrect and suspect to call for actual sacrifice from the American people, but I think it should and must be done. Whether it is in reference to the Wars abroad and our fight against extremists or healthcare, we need to demand people take personal responsibility.
On the Wars, if policy makers determine it is necessary to fight in Iraq, Afganistan and presumably other places then they should not only convince the voting public of this, but also that we must pay for it. This could be done through:
lower spending throughout the government
changed use of energy (higher utility bills)
mandatory public service
The point is that our lives shouldn't be the same today as on September 10,2001. That should not be the goal. In fact, we should be enduring some personal struggle that can be attributed to the need to fight the terrorists. The purpose could be to pay down our national debt somehow, avoid running up future debt, changing our oil use that will make us safer, or otherwise contribute in a personal way to making this nation better off. What we have in the alternative is a population divorced from the realities of war and not serious about the challenges we face. We have "fake crisis" syndrome where issues like the swine flu vaccine are elevated into national discussions rather than real problems.
On Health care we need to get serious about prevention. We need to reward healthy behavior. This will not sit well with people because many bad habits are impolitic to comment on. Whether it's risky sexual behavior, over-eating, not enough exercise, poor diets, refusal to follow proper medical protocols, etc. we need to change the way we live. The problem with health care is complicated but any honest person will tell you the most important piece deals with individual choices. We are torn because ultimately we don't want to dictate to people what they can eat and what they can/can't do, but if at the end of the day we as a society are going to pay for their well-being, we should take a more holistic approach and design a better system.
I think we need to design a system where both healthy people, and those who are doing everything they are supposed to do should pay less for health care and get monetary bonuses. We need to incentivize more healthy living. This will reduce the demand for health care services and drive the costs down for everyone. In addition, on balance people will feel better and live better. In addition, we need to divorce health care from people's jobs. This will not sit well with Unions because they now get tax benefits far more than they deserve. We need to establish a fair nationwide marketplace that deals with people as individuals, and allow them to join together voluntarily in groups to develop purchasing power. The beauty of America is the power of a free market and a rule of law that enforces the system. So this would be uncorfortable for many to allow a system that develops that encourages fitness and health rather than trying to find ways to pay for services to the sick later on. We need shared sacrifice.