Atul Gawande has an article at the New Yorker that's worth a read. Now, I've never liked insurance companies, and so generally would like to see either an expanded public option or full on single payer, but that only addresses the insurance company profits and denial of care and coverage. It does not actually do anything to change the medical culture we have going on in this country that is driving up the cost of care.
The article is quite long, but what it boils down to is: care decisions are made for the express purpose of generating revenue rather than based on evidence as to what the most effective treatment would be. This happens at many levels and is different in different locations. Despite places like Mayo Clinic, which offers some of the best care in the country at nearly the lowest cost, things are getting worse, not better.
None of the health care changes being discussed at the federal level really deal with this problem, and despite the fact that the poorer care, higher cost places (like McAllen TX) have lots of waste to eliminate, much of that waste is profit generating waste, meaning that the hospitals and doctors are not going to give it up so easily.
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