The problem is not insurance. First of all insurance companies are not that good at shielding patients from costs; most people have deductibles and out of netwo

The problem is not insurance. First of all insurance companies are not that good at shielding patients from costs; most people have deductibles and out of network expenses if they even have insurance at all. Second, even with insurance medical bankruptcy is rampant (the main cause of bankruptcy). Third, insurance companies have an obvious incentive to lower costs, it means they make more profit. They just don't have the power. This is something that changed in the 90s, when attempts at managed care tried to use insurance companies to push down costs. Hospitals responded by consolidating into local monopolies (provider networks) that insurance could not out bargain. The problem is simply that providers have too much power. Doctors regulate the supply of their profession; doctors in the US make 2X the oecd average. Pharma companies and medical get patent monopolies; drugs cost $300 billion a year above their generic price. Hospitals have local monopolies and patients don't know how to bargain for cheaper care; MRIs cost thousands of dollars. Insurance takes home a few paltry percent of every dollar spent on health care. The real takers are the health care providers, but we are all too busy shutting on insurers to notice.