The #1 reason Americans cannot afford health care:

[kenny blankenship]

34. That is but a symptom, an EXEMPLARY symptom, yet nevertheless ONLY a symptom

The real reason healthcare is too expensive, and stays that way despite the ACA, is

THE EXISTENCE OF A PROFIT TAKING MIDDLE MAN.

Obscene executive pay for this profit motivated middle man exemplifies the obscenity of a BUSINESS whose abiding and overriding interest is, as always, to prevent you from accessing the health care system; but the CEO's obscene salary isn't why the overall system is obscene. Health care is BAD in our country (with regard to outcomes and our shabby 3rd tier life expectancy) and health care is too fucking expensive (with regard to how much fucking money they extract every month) because your access is mediated by a profit motivated corporation. Not simply a business but a corporation, the ownership of which is diffused and traded among owners with no responsibility to you the consumer. They the shareholders have an interest in you DYING before you cost them any money, or at least before your treatment rises to significant sums. And therefore the management has an interest in your early death too, because they are expected to generate PROFITS - and that interest is exactly the same whether the CEO "earns" 20 million a year, or takes a "Steve Jobs" salary of one dollar a year. The insurance corporations of the United States are a CARTEL of just FIVE companies, with an apparently infinite number of subsidiaries, who are shielded from any antitrust laws. The members of the cartel are publicly traded for-profit entities and as such they MUST earn more every year than the last, or even they could face stock market extinction (even they, as vast as they are) First a share price contraction, leading then to a take over. Against their colossal size, against the remorseless logic of their capitalist structure and their inexorable, inexhaustible need to squeeze more and more and more profit from your body, you stand no chance. Absolutely NONE.