If you only read one blog post about health care this week, make it this one:

Ezra Klein – An insurance industry CEO explains why American health care costs so much

There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care. As Halvorson explained, and academics and consultancies have repeatedly confirmed, if you leave everything else the same — the volume of procedures, the days we spend in the hospital, the number of surgeries we need — but plug in the prices Canadians pay, our health-care spending falls by about 50 percent.

James Joyner has argued that in order to reduce health care expenditures we need to make a choice — we can’t have it be better, faster, and cheaper.  Yes, we can.  The reason we can is that the choice isn’t simply between better, faster, and cheaper, it is between better, faster, cheaper, and more profitable.  If you cut profits — for medical insurance providers, for medical malpractice insurance providers, for med-mal attorneys, for doctors, for hospitals, and for drug companies — you can have better, faster, and cheaper.  The problem is that our system is essential optimized for profits — our goal is not to make people healthy but to make people wealthy. 

I am all for the free market — but medicine is not a good item for a functioning free-market.  The barriers to becoming well-informed are high, comparison shopping is difficult, and people face monopolies and quasi-monopolies at all levels.  Our health care crisis is mostly a crisis of market failure.