Don’t forget that the AMA has a monopoly on billing codes. Medicare defines the billing value of every procedure as Relative Value Units (RVUs). Then Medicare defers to AMA’s guidance on what these values should be. Insurers default to RVUs x multiplier. So the AMA has the ability to set prices.

Oh, and patient value isn’t considered for these units. They are explicitly defined as input driven, so a procedure that is less costly to perform but has higher value to the patient will be billed at a lower value. Hospitals are incentivized to choose procedures that they can bill at a higher rate, and so because of these perverse incentives, they necessarily will ignore cheaper more effective treatments and choose the more expensive ones.

I’m a lefty, but the older I get the less I believe in the old New Deal style leftism I’ve been sold my whole life. As systems get more complex, they simply become a way to obfuscate oligarchic control.