There are lotsa issues in healthcare, not least that the medical association practices "birth control" for doctors. Plus the residency process to get board certified is absolutely grueling [1], I knew more than one doc who quit when they got their MD and got into startup land because it's an easier life!

It does seem that, against all odds, Obamacare really did "bend the cost curve" and slow down the growth in health care costs. After a rough patch decade or so when we didn't get new "blockbuster" drugs we are now getting drugs like Wegovy and Cobenfy which cost a lot but promise savings elsewhere.

[1] that said, a doctor really should know what to do when somebody with a rare condition that they'll only see once in their career and working a 996 schedule at a university medical center does give the experience for that.

Right, this take would be "zoning rules for MDs" with the caveat that healthcare outside of pharm can never be as uh industrialized as construction.

Things seem to get muddled with global pipelines (your breakthru drugs come from Nordic R&D) but I'd argue that therein (Obamacare-type bipartisan stewardship) lies the real argument for a "inputs-first" post-fossil Abundance