All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create. Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results.
This is a paradigm-shifting argument by a non-expert. Read the whole thing, and keep in mind that this has implications beyond the United States. Another important piece:
To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government’s role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy.
No politician is proposing anything like this sort of reform. Why not? Because politicians get elected by insisting that trade-offs do not exist. Of course trade-offs do exist, but you won't win a mandate by saying so. Keep that in mind as you read about the ever-shifting composition of the various health care reform bills being discussed in the Congress.