Whenever I contemplate America's healthcare financing crisis, I find myself sunk in the Slough of Despond and the Pit of Despair. America spends easily twice as much per capita on healthcare as the typical post-industrialised country. Yet US life expectancy lags behind.

America's doctors, nurses, pharmacists and molecular biologists do amazing things. But what things they do are constrained and controlled by the bizarre, disruptive and wasteful healthcare-financing system.