See Why Obamacare's Health Care Cost Controls Won't Work - Reason.com Obama's health care bill extending health care to low income Americans contained some sophisticated cost control measures. But none of them is likely to work based on empirical research on similar measures,according to this linked article.

A doctor acquaintance told me a generation ago that given medical practitioners' creativity in billing health insurers,the only way to control medical costs was through rigid,ruthless centralised government controls. Such controls can be a very blunt instrument,so they need to be implemented carefully.

The UK's extremely centralised NHS has been successful at cost control,though not without serious failures in a significant minority of hospitals. It looks as if Ireland's HSE is trying to emulate the NHS cost controls but weighed down with former County Health Board hangers on who should have been sacked years ago, it lacks administrators and managers as talented as those of the NHS to do the job.