Here’s a look at two conflicting narratives used to explain surging medical costs: The patients as culprits because they overuse healthcare  because much of it  is “free” to them  because of insurance and physicians and hospitals as culprits because they seek ever-higher revenue and personal wealth.

The authors conclude:

“{T]HE twin demeaning narratives of moral failure—by individual patients according to conservatives and by caregivers according to progressives—continues to animate health policy and drive us toward simplistic marginalist economics solutions that reduce physicians and patients to merely economic actors.

“The real story of what creates health and drives health spending is far more complex than these cartoon narratives suggest.

“We need a more complex and balanced explanation of what creates health, and a more comprehensive set of solutions that implicate public health and the human services, as well as individual citizens and the care system. The care system by itself cannot improve Americans’ health.”