I am going to spitball here. There is more to our health care system in the USA than is being addressed here. I am old enough to remember how things were before the Great Society Program that established Medicare and Medicaid. Doctor visits and prescription drugs were generally affordable for most people. My pediatrician visits were $7.50 in 1963 in Los Angeles. An injection was another buck. (After my dad died four years ago we looked through some of his budget records from the early 60s, and these were listed.)
Medicare came along, and suddenly intermediaries were processing claims that were paid from government funds. It took decades for the government and intermediaries to figure out how much to pay for each type of service. Part A inpatient was reimbursed under a cost reporting method, where all overhead was stepped down to the various revenue centers for hospitals. I won't even mention how the physical therapists gouged the system--lawfully by exploiting loopholes.
As the years passed, the medical industry standardized treatment and diagnosis codes that were available to insurance companies. The rates of reimbursement by Medicare were published and well-known. Is it any surprise that many payments allowed by the insurance companies are nearly identical to what is allowable by Medicare? Compare EOBs for the same physician for the same treatment for the same diagnosis and you will be amazed!
Advances in technology. Decades ago, there were no MRIs, no CRTs, no Lasik surgery--the list goes on and on. This equipment and the labor needed to operate it are expensive. People live longer thereby incurring more health care needs as they age.
Finally, there is a huge supply-and-demand issue. Our population has exploded, while the number of medical providers has not kept pace. I wonder if we had five times the number of qualified medical providers if our costs of health care and insurance premiums would be the same as they are, or if they would be less.
This area is quite complex--certainly beyond me.
