One issue that does not get enough attention is the prosaic act of shopping. I spend my own money, and I care about price. I spend someone else’s money, I don’t give a rip. Josh Cothran did a visualization of who is spending health care money. Just look at the 1960 and 2012 charts, and pay particular attention to the orange “out-of-pocket” number. Another way to rewrite these charts is to say consumers care about prices for spending in the orange band only.
Also, healthcare providers only care about your happiness to the extent that you’re paying them. If you’re not paying out of pocket, they don’t care whether or not you’re happy with your healthcare.