"Bureaucratic Rule of Two: Removal of an activity from the private to the public sector will double its unit cost of production." -- Thomas Borcherding, BUDGETS AND BUREAUCRATS: THE SOURCES OF GOVERNMENT GROWTH
I found this article thanks to a combox post over on Father Longenecker's blog. The author, David Goldhill, does an excellent job of explaining why our health care system is so dysfunctional.
A synopsis, if you think it's too long to read, boils down to the King of Id's Golden Rule: Who has the gold, makes the rules. We are not the ones who provide the gold, so we do not make the rules. Medicare, Medicaid, your HMO, Blue Cross/Blue Shield, and other insurers are the ones who make the rules. And they make those rules, whether they mean to or not, to benefit themselves. Any benefit we receive is almost an accidental by-product.
I may not agree completely with Goldhill's proposed solutions; I have not yet given them enough thought. But I think he has his pinpointed the systemic root of the problems that most strongly draw our attention.