Oh, Psai. There there. It's Friday! Buck up little camper. First, now that you're a grown up, when somebody send you a link, you need to read the grown up words and not just look at the pictures. The article talks about the slowed growth of expenditures as not being related to decreased utilization. I was pretty clear the link was in response to your utilization comment...i even quoted you just before the link. Hard to make that more clear. Very hard. Yet, you seemed to screw it up.
Regarding the rest of what I guess we'll call your "contribution"; So, what you're saying, is that the healthcare delivery environment is changing? Well, that never happens!! It didn't change when the first HMOs started to show up in the 1980s, or with OBRA, or HIPAA, or with DRG, or ICD-9, or ICD-10, or in the 90s when many small hospitals went bankrupt and closed. It didn't change at all when MAPD was passed either. Yes, the healthcare landscape has been an absolute rock all these years, and then the ACA came along and just look at it now! Our perfect system is ruined. I remember the good old days when friends with children would be denied coverage of asthma medication because they owned a fireplace (this happened to my cousin 20 years ago), or when people would have the nerve to get cancer and then the righteous insurance company would kick them to the curb, or any number of other super f'd up things that would go on that perhaps you're just too young to remember.