The simple fact is we are spending too much on health care. The health care cost discussion remains facile, avoiding the hard edges of the decision-making process. Health care costs consist of 1) profits, mainly those of insurance companies and for-profit hospitals, 2) administrative costs, and 3) the cost of health care itself. We can cut 1 and 2 by going to a national single payer system and reverting back to community owned non-profit hospitals, ambulances, and clinics. Controlling the actual cost of health care would require rational rationing (instead of rationing by money, which is what we have now) and a strong, tough-love approach to preventive health to cut the costs of obesity, diabetes, slothfulness and nutritional suicide. And yes, death with dignity as opposed to plug 'em in and let 'em linger would have to be part of the solution.
---CKM
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