It's so many different things, as usual, that make the problem what it is. Anyone offering up any one thing as the problem (re: fat people, overwork, profit systems, doctoring via pharmaceuticals, Mexicans, etcetera) make good points, but are missing the big picture because it is so damned big and multi-valued.
Insurance companies are another example of the problem, but again, not the whole problem. They are no more than Vegas bookies, gaming the odds in such a way that they can profit massively from the system by paying out a great deal less than they take in. They are just as much a middle man as any government agency would be, but people who hate the concept of taxes being used collectively can feel kind of happy knowing that their money is at least being directed back at them and their families (even though it's also being directed at a desk jockey to pay for his nice house and car, although he has nothing at all to do with the procedural end of medicine).
I used to do medical transcription on the side and it would be impossible to count how many times I heard doctors getting literally pissed talking into their dictaphones that some necessary procedure or diagnostic study was refused by the insurance company. I had one even saying he was going to write a letter to congress, because his patient absolutely needed physical therapy on a work-related injury and it was getting consistently denied despite second and third specialist opinions, which ends up being payment for nothing.
Insurance companies are another example of the problem, but again, not the whole problem. They are no more than Vegas bookies, gaming the odds in such a way that they can profit massively from the system by paying out a great deal less than they take in. They are just as much a middle man as any government agency would be, but people who hate the concept of taxes being used collectively can feel kind of happy knowing that their money is at least being directed back at them and their families (even though it's also being directed at a desk jockey to pay for his nice house and car, although he has nothing at all to do with the procedural end of medicine).
I used to do medical transcription on the side and it would be impossible to count how many times I heard doctors getting literally pissed talking into their dictaphones that some necessary procedure or diagnostic study was refused by the insurance company. I had one even saying he was going to write a letter to congress, because his patient absolutely needed physical therapy on a work-related injury and it was getting consistently denied despite second and third specialist opinions, which ends up being payment for nothing.