What I haven't seen mentioned is the identification of "providers". The days of your doctor being the 'provider' are long gone. Providers are now large corporations and, interestingly, the largest "providers" are health insurance companies.

Point 4 of an article[1] about health delivery is quoted below:

>>Perhaps the most underappreciated transformation of the past 40 years is the corporate consolidation and financialization of medicine. Care delivery—once local and community-based—is now dominated by corporations.

>>Vertical consolidation is now a defining feature of American health care. UnitedHealth Group isn’t just the largest insurer; it’s also the largest employer of physicians and the largest operator of home health and hospice agencies. CVS Health, the largest pharmacy chain, also owns the biggest pharmacy benefit managers—and now giant insurer, Aetna. McKesson, a pharmaceutical distributor, now operates the nation’s largest chain of oncology practices and is rapidly expanding into other specialties. These combinations raise all the conflicts of interest you’d expect—higher prices, business steered away from independent providers and pharmacies, gaming regulations, and more.

[1] https://yourlocalepidemiologist.substack.com/p/aca-health-ca...