ABSTRACT
There is a huge amount of confusion in this country about why health care costs and health care premiums are going up. Most conversations on that topic sound a lot like the old “blind men and the elephant” fable — where the blind man who has hold of the tail thinks the elephant is a snake and the blind man touching the shoulder of the beast thinks the elephant is a wall. Just about everyone interested in health care reform has his own pet culprit as the key and primary cost driver for care. Drug costs, drug company profits, imaging costs, physician fees, hospital costs and hospital cost shifts, billing fraud, insurance company overhead, administrative overhead, malpractice suits, defensive medicine, primary care shortages, regulatory paperwork, and medical technology expansion all have their advocates as being the key cause of health care cost increases. Those factors all play a role in health care cost increases — and none of them, by themselves, explains very much of the cost situation.
