Not just expensive to the patient (but yes, that too) - expensive for the government, both on a per capita and a per outcome basis. Turns out that when you insert middlemen with a profit motive, they extract money from the system? Who would have thought

also horrifically exploits med students and early career doctors!

Health care bros are the original Elons Musk, latching on to the government's teat in exchange for providing the bare minimum that they can get away with while lobbying to lower even that low bar

WORD? Could not have come to this conclusion through any forecasting

Inconceivable

The other aspect here is social determinants, which have the biggest impact on clinical outcomes. A healthcare payment system can be world class but if food insecurity, housing, transportation, literacy/communication, and loneliness (a biggie!) are not solved for, clinical outcomes will still fail.