Megan McArdle: It's worth noting that, at least anecdotally, the internet means we're increasingly exporting our [health care] cost inflation to other countries. In the 1990s, [foreign] breast cancer patients wouldn't even have found out about a treatment like Herceptin. Now they fight (and win) public relations battles with their governments to get their treatments covered, even when the treatment is not deemed cost-effective by the health care regulator. And the woman who fought that famous and "inspirational" battle in Britain recently died; the drug didn't buy her that much extra time, perhaps because she had to fight so long to get it.
If your mother or your daughter or your sister or your wife is dying of breast cancer, it doesn't matter to you how much the treatment costs relative to the benefit. And indeed, the political battle over health care is infused with the belief that you shouldn't have to think about cost--that it is immoral to deny anyone a treatment that might help them.
Unless we're willing to let health care expenses grow unchecked, someone is going to have to think about costs. But so far in America, I see no means to develop a culture which will allow bureaucrats to deny potentially life-saving treatments simply because they're costly--either in the free market or in a single payer system. Thus, I predict, costs will continue to grow.