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not the least of which is that wages haven't kept pace with true inflation for the past 40 years, meaning anything created domestically like the health care industry is going to outpace anything we can get offshore in cost increase over time relative to wages.
Another thing driving costs is administrative overhead, from redundant bureaucracies in competing plans to bureaucracies in everything from doctor's offices and hospitals to deal with the often Byzantine paperwork they generate. Greed comes into play here because this is where the cadres of people whose jobs are to delay or deny coverage and care come in. It also covers stockholder profit and executive pay, plus advertising.
Still another thing is redundancy of expensive technology within a health care market. It's no secret that MRI scanners have been ridiculously overbuilt in this country, each competing hospital feeling the necessity to have the latest generation machine at all times when one or two machines would likely serve the whole market as well. This is why the Canadians famously schedule their MRI scans in the US. We overbuilt and charged ourselves a fortune for the privilege so they didn't have to.
Health care itself is labor intensive, and that will always drive costs that can't be contained without degrading service to the point it becomes more dangerous to seek care than do without it. We're almost there now, with cost cutting on the backs of health care staff at the maximum.
Single payer, the elimination of redundant bureaucracies, the consolidation of services and the common sense specialization of hospitals, and strict regulation can reduce the ridiculous costs we're bearing now while covering us all. However, don't ever expect health care to be inexpensive. That's why insurance to cover it is so desperately needed. Until we can pick and choose when and how to become ill, health care can't be forced into the consumer marketplace as a way to cut costs.
It just doesn't work that way.
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