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To the seriously sick, effective medical care is priceless. But not everyone who goes to the doctor is gravely ill, nor is all health care effective yet someone has to foot the bill. On the bright side, there is now much clearer evidence that medical care pays off in healthier and longer lives. In America, publicly financed health care goes mainly to the old and the poor as opposed to the Canadian model, in which taxes finance the free use of hospitals and doctors for all.

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The medical sector has been slow to invest in information technology, which holds great potential to reduce errors and improve efficiency and quality. Such medical errors result in human tragedies and also wastes a lot of  money because of compensation claims. Health care is also poorly co-ordinated, which is a particular drawback for the growing number of patients with chronic conditions requiring sustained rather than occasional medical care. Furthermore Effective integration of services provided by primary-care physicians and hospitals is still all too rare.All this suggests that the system reflects the priorities of providers-doctors and hospitals-rather than consumers.

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Whether cost containment takes the form of budget caps or price controls, it leaves the structure of health care and the underlying power of providers intact and the best hope for successful reform lies in making it easier for health-care insurers and group purchasers to bear down on providers directly. While Medical advances such as vaccines and antibiotics against infectious diseases have clearly done much to improve people's health, Monopolies, such as drugs under Patent increase medical cost. The new forms of surgery have been found to be less invasive and allow swifter recovery. Inefficiency also stems from poor allocation of resources across different parts of the health-care system.

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