There's a lot I don't know about this stuff, but it seems to me that a Capitalist approach to healthcare has been the root of every ill that plagues our ridiculously unsustainable system. Every player in the game, like any good Capitalist, is constantly out to increase his profit margin, with the lone exception being the contingent of doctors who haven't lost sight of the promise they made when they took the Hippocratic Oath. The art of medicine is, in principle, a Socialistic endeavor, which makes it, at a very basic level, incompatible with a Capitalist system. In order to make the increased profits all business owners strive for, providers are forced to either refuse care to Medicare/Medicaid patients or raise their prices to keep pace with the ever-increasing costs to insure their practices and the ever-decreasing payouts from insurers. Refusal to care for any person is a direct violation of the Hippocratic Oath, so the ethical doctor has only one choice.

Something else that I can't imagine has helped matters has been the introduction of corporate ownership of medical practices in the past few decades. My father's group practice was purchased by a corporation in the mid 90s. Not long after being "acquired," my father was called into his "manager"'s office (a 30-something administrator, earning about $250K per year while providing ZERO healthcare) and was fired because he had "too many Medicare patients." He has since started a new private practice and continues to serve his Medicare and Medicaid patients, but he's earning less than he did 20 years ago....

In summary, a mish-mash of insurance companies, big pharmaceutical producers, corporate overhead (and greed), malpractice attorneys, and the greedy contingent of providers has probably accounted for at least a good portion of the drivers behind the hopeless misery that is our healthcare system.

I don't pretend to have a solution, but I think some of the more moderate changes proposed in this thread would be a good start.