So why does American health care cost so much? The main reason is that the person receiving the service is not the one paying for the service. Imagine if you could go to Safeway or Giant, fill your cart with food, and then have someone else pay for it. Obviously you would get all kinds of stuff you don't really need. Obviously the food chain would charge whatever it felt like, and you wouldn't care, because you would not be the one paying. Now imagine further that the third party paying for the food was itself relatively indifferent to what it was charged. It raised its money through premiums paid for by millions of customers, and it could simply pass the cost to those customers in the form of higher premiums. This would be a scenario virtually set up to ensure runaway food costs. We don't have it for food, but we do have it for health care.