I agree with you on calling out the moral absurdities in our health care system, and how that is a reflection on our level of social trust. I'd like to see chan

I agree with you on calling out the moral absurdities in our health care system, and how that is a reflection on our level of social trust. I'd like to see changes, also. Cynically I would say that politically we have optimized for profit and bureaucracy. Would I be wrong? I'd say that this is because our democracy is imperfect - money, corporations, and corruption are driving too much of our politics. It's always bothered me that so many people would presume to fix health care at the federal level. For a while Congress has been one of the least trusted institutions in the country. Why do we expect them to fix anything? The Affordable Care Act was anything but that, it did nothing to control costs or fix all the pricing transparency problems. Poor folks get a free yearly visit and screenings but have to pay a few thousand dollar deductible when they are sick (money they typically don't have) before they get any covered care, while the government subsidized insurance premiums go right past the recipients directly into the pockets of the insurance companies. I'd be more comfortable seeing something like many of the countries in Europe have, price controls on drugs and simple standards set at a national level, with implementation details, tax collection, and administrative details left to the states or provinces. The states were just starting to innovate before the ACA. Vermont tried single payer. Massachusetts had Romneycare. NY and California we making plans, etc. With the ACA the feds commandeered the whole thing, and didn't do so great a job with it. I think that the states are in a much better position to fix this, but that the insurance companies and other related incumbents would rather have this controlled from a federal level where they can most easily influence the outcome to be in their favor.