Part of the problem is that most people don't pay (at least in ways they can easily see) for their own medical care. Have you ever tried to price shop for medical care? I have - it is impossible. Suppose you are getting some routine blood tests. You can't call a hospital and asks what it costs. The person who answers the phone doesn't know and has no way of finding it out, and treats you like you're crazy for even asking. Of course costs are out of control. Imagine if you didn't pay for your own car... would you shop around? Would you visit different dealers and negotiate the best price? Or, if someone else is paying, would you just go down to the nearest Mercedes dealer and pay list price? it's the same thing with health care. People don't price shop. And those few who want to price shop can't. Medical care is not somehow magically exempt from the laws of economics. I don't know what the answer is, but any system where the people who benefit from the product/service are not the ones to pay for it will result in very high prices.