The American Health Policy Trap

The American health policy trap: a costly and complicated system that has left a growing minority of Americans without financial protection in sickness but has nonetheless satsfied enough people to make it difficult to change. The key elements of the trap are a system of employer-provided insurance that conceals its true costs from those who benefit from it; targeted government programs that protect groups such as the elderly and veterans, who are well organized and enjoy wide public sympathy and believe that, unlike other claimants, they have earned their benefits; and a financing system that has expanded and enriched the health care industry, creating powerful interests averse to change.

Paul Starr, Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform