ABSTRACT
Obviously, health care markets in the US are functioning poorly. The present system amounts to a refined form of a jungle raj rather than a properly regulated, functioning free market. It is not unlike many poorly governed underdeveloped countries lacking proper institutions. The US health care system needs adult supervision. Clinging to the misguided belief in Americans that all markets are always and everywhere necessarily efficient is false and harmful as evidenced by the unsatisfactory performance of the US health care system over many decades. The sources of waste and dysfunction in the US health care system are well-documented now. This chapter looks at the key drivers of waste/dysfunction in the system and which system insiders are responsible for them. More work of this nature is needed rather than the current academic, out-of-touch policies, interventions, and approaches that amount to mere intellectual masturbation of sorts. There is need for more urgent and practical action and the will to challenge the powerful insiders, but not conveniently to keep playing along with them.
