Jamok,

Good post, I think you have captured a good deal of the issues with the system, perhaps only missing a few.  There is no question that because the system is made up with human beings it is subject to so many abuses, including the Medicare fraud (rampant here in South Florida), and as you mention, big Pharma being out of control.  Then there is the impulse for a Doctor to do more tests than necessary (which may be performed at labs they own).  In short, it only takes a small percentage of players in any system to skew things negatively and drive up costs.

BTW, I am glad you mention that even though there is a negotiated price, Doctors and Hospitals still pass on some of the unpaid bills to the patient, it always ends up hitting the patient's pocket book, this, even as we are paying increasingly more for our coverage every single year.  In my case, my coverage went up by 7% this year, or about three times the rate of inflation. Now, I understand that things cost more every year, but I consider this intolerable, it is contributing to this country's troubles in an insane way.

I believe that given the fact that Medical care continues to far outstrip inflation (for decades if IRRC), resulting in an ever increasing cost for healthcare and forcing employers and Obamacare to pass on these costs, that it will eventually (who knows when, but it will) change people’s mindset and accept a single payer system.  Obamacare is but the first step towards that.

I would propose a system where employers are not off the hook, they would still pay a special tax which would be targetted for this purpose (I know, I knwo politicians would loot it) and of course there would be higher federal taxes for tax payers.  One way or the other we are still paying for this massive system (the saying: there is no free lunch comes to mind), so why not face up to it and fix it once and for all?

If we did, maybe its costs would be on par with European countries where they pay quite a bit less than we do on a per capita basis.