I don't agree that insurance companies would not want to sell policies to all people. That is like saying that stores only want to sell to rich people. They might prefer rich people but there is plenty of money to be made selling to poor people.
But I do stand corrected in that I never intended for group policies to cease to exist. A free market would allow for groups to form.
Aside from lack of market forces I think medical care is more expensive in the US in large part because more people have private rooms and we have more machines and better paid doctors and we do more ground breaking research, and we do more cosmetic procedures, and we do more of all sorts of elective procedures, etc. And we have better outcomes on the important measures like cancer survival rates.
In short it like shopping at Target versus Walmart. The quality of merchandise and the ambiance is better at Target so it cost more. One could live shopping only at Walmart but given the choice enough will choose Target so that the average cost of what they spend goes up.
Additionally, it is more expensive not just because we get more but because we are sicker. Costs for things that are unrelated to health care policy drives the costs up - things like a high rate of violent crimes and obesity and poor lifestyle and maternal choices.
Add in the fact that various governments lie about how well their countries are doing and massage the data and the services offered to lower actual or apparent costs and there is a bit more wiggle.
The problem as I see it is if one wants Walmart quality (and prices) but lives in Target-land how will that person get lower costs? Only if a person can choose to go to a substandard care center can they do that and the regulatory climate in our country does not allow for intentional substandard care centers. Of course Canada offers plenty of lower quality care (see posts above).
Do insurance companies and law suits add to it? yes.
Fraud and corruption? Yes.
Un-needed procedures? Yes.
