This is the editor's letter in the current issue of The Week magazine.

Our health-care system has a fundamental flaw: It's far too expensive. Americans spend $3.3 trillion a year on health care, which is 50 percent to 100 percent higher per capita than in other developed nations. For our money, we get some of the world's most sophisticated treatment of cancer, heart disease, and other serious illnesses. But overall, U.S. health care is relatively mediocre, producing shorter life expectancy, higher infant mortality, and worse health overall than the systems in such countries as the U.K., Switzerland, Canada, Australia, and Sweden. RyanCare won't fix a broken system; ObamaCare didn't, either. Both were conceived as patches on an absurdly complex Rube Goldberg machine assembled over 75 years of haphazard decisions. Studies have found that 34 percent of the immense cost of our system is simply wasted, with no benefit to patients.

Is health care a commodity like any other, which you can either afford or cannot? Or is it like education, electricity, or police and fire protection — basic necessities that government should ensure that everyone gets? We can't decide. Our system is a clunky, free-market/socialist hybrid that ties coverage to employment, age, and income, with tens of millions of people falling through the gaps. Meanwhile, doctors, hospitals, insurers, drug companies, medical device makers, and malpractice lawyers strive to make as much money as possible tending to the sick. The average hip replacement in the U.S. costs $40,364; in Spain, $7,731. In the U.S., an angiogram is $914; in Canada, it's $35. Lipitor costs $124 per month here, and $6 in New Zealand. This is the elephant in the room. To address it, and to make health care truly available to all, would require radical change. But too many people and companies have a vested interest in a health-care system that's the most expensive and inefficient in the civilized world. So that is what we’ll continue to have, no matter whose name precedes "care."