Alain Enthoven has a review of the problems of cost containment.
What should be done? I explained it in my “Consumer Choice Health Plan” articles in the 1978New England Journal of Medicine. The idea is also in a recent report by the Committee for Economic Development (CED). The general idea is for government to pay everyone’s way into the purchase of an efficient or low-cost health plan, meeting standards in their state or region but no more; if people want something that costs more, they must pay the difference with their own net after-tax dollars. Additionally, the creation of exchanges that broker multiple choices of health plans would drive the delivery system to produce better value through consumer choice and competition.