These debates about insurance and payment models are important, but still ignore the biggest issue. US healthcare expenses increasingly go to treating conditions caused by poor lifestyle choices: obesity, substance abuse, and sedentary lifestyles. Certainly there are ways to cut waste and shift costs around more equitably but unless we can improve those root cause factors we're only going to be kicking the can down the road. At some point we just won't be able to provide effective care to everyone regardless of who's paying or how much providers cut prices.

Even countries with socialized medicine are going to run into the same issue. Canada and the UK are only slightly better off in those lifestyle choice factors than the US, and their trends are moving in the wrong direction.