Our system in the US is very complicated and the fault is not all the politicians although quite a bit. What happened is the Insurance companies lobbied for insurance to be deductable under if employers offered it as a benefit. This worked great. The insurers got paid by the employer to pool funds and they paid the mWe reedical bills. and the insured had a small percentage of the costs. In a nutshell, Doctors raised rates because their requirements were increased, patients used services without regard to cost because alot of time they didnt pay for the whole thing. Physicians began to pay more in malpractive so they began ordering more cover your *** tests that werent previously used. So really everyone is responable. I havent mentioned the hospitals and pharmacueticals as well. I can tell you that I prefer having commercia insurance that I used to have before I lost it as a result of Obamacare and had to get my care at the VA. The VA has nearly killed me on a couple of occasions and right now I get my care from someone 8 hours away who, despite multiple medical issues, is a Physicians Assistant instead of an internist. When I worked for Aetna US Healthcare in Physican Relations we had requirements for patient access and we incentivised physicians for quality healthcare. We reviewed patient charts to make sure that physicians provided immunizations and diabetics had their A1c checked etc.