All key parties are to blame. That is, hospitals, insurers, pharmaceutical companies, suppliers, physicians, the government and yes, the consumer, are all to blame for this state of affairs.

Here are some of the dysfunctional behaviors that contribute to the current problems with our health care system:

Payers (Insurers)

  • Shift costs to patients, hospitals and MDs
  • Cherry pick patients, deny coverage


  • Consolidate to gain bargaining power
  • Shift costs to MDs
  • Hide prices
  • Build facilities, then create demand
  • Over-bill the uninsured


  • Consolidate to gain bargaining power
  • Self referral, self serving treatment plans
  • Avoid sicker patients
  • Favor expensive treatments over proven methods

Device and Pharmaceutical Mfgs.

  • Off-label uses (pharma)
  • Hidden payments to MDs
  • Extremely high prices for some drugs or devices


  • Annual open enrollment and short-term focus


  • Demand services with no proven benefit
  • Poor behavior, e.g. bad diet, little exercise