KANSAS CITY, Kan. - Health care reform in the U.S. is difficult because we have assembled the most complicated, convoluted, inefficient, un-systemic health care "non-system" of the industrialized nations.
The two biggest cost drivers are the American lifestyle of too much food and not enough exercise, and, the payer "system." Changing these two factors are "extremely difficult" and "difficult."
Health care reform in the U.S. is difficult because the elected officials who are to change or reform the non-system seldom get the opportunity to truly learn and understand the vagaries of Medicaid, Medicare, SCHIP, the Veterans Admin health system, ERISA, federal regulations, state regulations, and more.

