Naked Capitalism has published the article What the US “Health Care Reform” Debate Did Not Address.
Despite some protestations to the contrary (e.g., here), the US health care system has been plagued by dysfunction. According to a recent Commonwealth Fund study, the US was ranked 11 out of 11 in health care quality, but 1 out of 11 in costs. Traditionally, health care reform has targeted ongoing problems in the cost, accessibility and quality of health care. The ACA notably seems to have improved access, but hardly addressed cost or quality.
Early on we noticed a number of factors that seemed enable increasing dysfunction, but were not much discussed. These factors notably distorted how medical and health care decisions were made, leading to overuse of excessively expensive tests and treatments that provided minimal or no benefits to outweight their harms.
When I try to think about why medical costs are so high in this country, I can only imagine some of the things pointed out in this article. Only an insider gets to see all these aspects.