Excellent article. I’ve spent a bit of time professionally looking at these issues. One comment I would add — the entire marketplace is structured as cost plus. All of the players, especially the insurance companies (who’re more often than not administrators and not actual risk-assuming insurers) are incentivized to make costs for care as high as possible. This encourages bad behavior by payers and providers — compounding the cost of care.
Perhaps this time we will actually get at the real issues of costs and patient outcomes. I’m skeptical, but hopeful.