“Standardizing an interface between health care providers and insurance companies would be a huge win. No matter how badly designed, it would be better than the current mess, and save several percent of US GDP.”
A new regulation was actually proposed by the federal government a year ago to do that: https://www.cms.gov/priorities/key-initiatives/burden-reduct...
There’s also a new program to reduce fragmentation for dementia care in particular: https://www.cms.gov/priorities/innovation/innovation-models/...
Solving the sorts of problems highlighted in the article (from 2017) is well-recognized, by elected officials in 2023, as a priority of their constituents.
However, neither of the initiatives linked above will systematically address the underlying issues, which are:
1. Conflicting and overlapping objectives between federal, state and local governments, as well as between the different branches of government.
2. Partially privatized administration of government programs, such as Medicare. This inevitably results in further conflicts of objectives, and incentivizes gaming the system.
3. The only real way for the government to learn from failure, and adapt to it, is by creating a mountain of new regulations, which just makes everything more expensive / take longer.
4. Extreme caution, in regulated industries, around sharing information with external parties, due to liability concerns. This drives further consolidation.