It might be interesting to read Ivan Illech: 'Medical Nemesis.' It's a small non-technical book that resulted for a paper presented by an economist to physicians well over 60 years ago. It may still be a standard text used in some medical schools.

I can't summarize even the basic ideas, but from Illech's economist perspective the costs of health care are uncontrollable except for one possibility and that isn't very likely to happen. Uncontrollable rising costs eventually would destroy the system and over a half-century later many might say have destroyed the system. From his perspective, neither organizational, administrative reform nor increase in health care workers will solve the problem. It's the reading of the 'why fors' that might interest some people.

What the unlikely solution? It like many things, it's us. The only way to control costs is for individuals to take responsibility for our own health. The problem is that the health care industry is a monopoly and prevents us from doing that even if we see the need and so desire. Your Doc owns your body and is gatekeeper to the care of it. Health care is one of the few places where adults are allowed child like roles. Our demands are unbounded and the system works to keep us like that. Illech was telling physicians that their instincts, training and behavior is part of an almost un-solvable problem. Those in power have to give up some of the power in order to solve the problem. Exercise of individual responsibility is the solution and should be rewarded but it's often criminalized. Sounds like much of the rest of modern life.

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