the most unpopular politically. A large (if not the largest) factor in rising costs is the isolation from the consumer (the patient) and the real costs of care (either via insurance and/or governmental assistance). Demand for services drives up the price and if someone else is shouldering the majority of the burden, there's no reason to demand more when it comes to care. What do I care if the doctor orders expensive and/or redundant testing if my insurance (or the government) is picking up the tab? As I've said before, we could have 1970s health care costs today if we willing to accept 1970s level care. We've come to expect the latest and the greatest (often in the absence of results-based evidence) and will settle for nothing less.