Yes, this is a general problem, but that doesn't mean that it can't be ameliorated. One of the most insightful things I read about health-care reform in the U.

Yes, this is a general problem, but that doesn't mean that it can't be ameliorated. One of the most insightful things I read about health-care reform in the U.S. was this: a lot of people on the left would have preferred a single-payer system to what was actually enacted, but that really wouldn't have been feasible in the U.S. The reason single-payer is successful in keeping costs down is that the government sets prices. There's a committee of experts somewhere that sets prices of drugs, procedures etc, and periodically adjusts them based on technological advances, market conditions etc. This couldn't work in the U.S. because the pricing body would be subject to intense lobbying by medical suppliers, and would quickly reflect their interest in keeping prices high, rather than the public interest in lower prices. (I wish I had a citation, sorry.) So does that mean single-payer medical systems are impossible? No, of course not. It works fine the U.K., Canada and Taiwan to name a few. In those countries, the kind of lobbying that dominates politics in the U.S. is simply illegal. At the same time, not all special-interest lobbying is harmful. Consider the case of wheel-chair users. They represent a tiny fraction of the citizenry, but they benefit greatly from a law that requires public buildings have wheel-chair access ramps. That would saddle the majority with a small cost, but the public doesn't care either way. So the wheel-chair lobby has to put effort into getting the law passed, and it's a good thing if it succeeds! So, yes, this is a general problem that has no solution. But that doesn't mean that corruption on the scale and scope that exists in the U.S. is inevitable, or that it's not really hurting U.S. democracy. It is.