1) Technological innovation is largest contributor to health care inflation. I might add the over-use of this technology. As an example we do more than twice the MRI’s that other developed countries do.
2) Overall, we don’t have better health care outcomes than countries that spend much less of their GDP.
3) The fee for service system is a culprit in the context of third party payers. It permits doctors and hospitals to pad services. It is a reverse incentive to lower health care cost.
Most should agree that the direct pay or predominance of third party payer also has bore a heavy burden on cost containment.