Maggie's Farm

There are a lot of reasons why health care costs rise. Inflation is certainly one of them. Technology is a big driver of costs, especially "crisis" technology like cancer chemotherapy and cardiac surgery. These expensive therapies save some lives, extend others, and have no benefit for some people. The question, of course, is when is this care "wasteful"? We often don't know that it's going to be futile until well into the course of treatment. And the technology doesn't have to be new to be expensive: we've been doing cardiac transplants for 40 years and they're still very expensive.
"Defensive" medicine -- lab and imaging studies, or treatments liek defnsive c-sections that look good in court -- surely account for some of the waste, but they would be a pretty small amount.
Cost control in healthcare is a chimera. It's true that people might not pay $5,000 out of pocket to have hip replacement surgery, but then we would have people getting around in pain.
My own theory would run along the lines of "major medical": each family pays about $300 per month in premiums and they pay the first $3,000 each year in health care bills out of pocket. (These numbers for illustration only). Minor care reverts to a family budget item -- am I willing to pay $250 to have this mole removed? Major care shifts to the insurance pool: my $25k melanoma treatment after that $250 mole job. (No, I don't have melanoma -- just illustration again.)