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“These insurance middlemen are glaring examples of the consequences of a vertically integrated health care system ….”
I think you have it completely wrong. The problem IS that we DON’T have a “vertically integrated health system.” Instead, we have a desperately fractionated national health care system, structured in a way where each stakeholder, particularly the insurance industry, is incentivized to take their cut of profits. The cumulative result is that health care costs continue to out pace inflation and are on average twice the costs elsewhere in the world while health outcomes are among the worst in the industrialized world, translating into the lowest value. Well designed vertical integration would improve efficiencies, reduce cost, and better coordinate care thereby increasing value. The savings could be returned to taxpayers, policy owners, and could fund many health promoting initiatives.