If we nationalize health care, the state (being the one that pays) will make such decisions ultimately (under Hillarycare it would have become criminal to accept payment for medical services, just as prostitution is illegal).
Vast chunk of our health care dollars are spent on elder care during the last 6 months of life. If we just shot them up with morphine, and didn't try to save "lost causes", we would have lower insurance premiums, but I wouldn't like the society we would have become.
"One way to cut costs is to pay attention to outcome studies, cost vs outcome."
You mean cost effectiveness studies. Not everyone can have brain surgery. Not everyone requires it. Not everyone can pay for it. That doesn't mean the system is wrong. If everyone needed brain surgery, the costs would be greatly reduced. Instead, everyone needs pills, and they are greatly re...oops, they are high too. Hmmm. The goal of the pharmacuetical community is not to heal you. Its to use pills to prolongue your life so that you can buy more pills and keep stock up. :) Well not all pills.
Much of the problems are preventative diet and habits. And yes folks, smoking is one of them, as is overeating. I shouldn't have to pay for it either through taxes, or increased insurance premiums. Frankly, you live badly, you die early.