Pure Paul Krugman: Healthcare Costs

"The point is that if you want to control Medicare costs, you can’t do it by kicking a small number of relatively young seniors off the program; to control costs, you have to, you know, control costs...The key is having a health insurance system that can say no — no, we won’t pay premium prices for drugs that are little if any better, we won’t pay for medical procedures that yield little or no benefit."

This from his blog. I'd only add that we also need to figure out a way to say "no" to the needless prolongation of life in ICUs in people who have virtually zero chance of recovery. It accounts for an enormous amount of our expenditures, although I don't have the references on that at my fingertips.
--br