This is one of the places I can relate to the most having worked in healthcare for 2 years in India. Cost. I knew that the cost of healthcare was much higher in the United States than we have at home, which I thought was due to the high quality and high personnel costs in the United States. A Harvard economics article I cited put things into perspective and made me think in a completely different way. At home, I probably know people who have never made an appointment to see a doctor. Surprised! Think about the last time you wanted to make a doctor's appointment and had to wait 2 or more weeks to see him. Don't you think that if you had a common cold, it would automatically go away with a little rest and home care. And if it was something more serious like malaria or dengue fever, you probably would have seen your doctor in the emergency room well before your appointment. On an average, while a doctor sees 20 patients per day (according to a doctor I know here), in India an average doctor sees 45 outpatients and 18 inpatients per day. There are some days when a doctor would see 55-60 hospitalized patients per day. (don't be surprised, it's not just Friday the 13th). The waiting line to see the doctors is not a pleasant sight at all. Imagine my frustration when an international patient (no offense) asked me that if all patients had an appointment, they wouldn't have to wait so long. She also didn't have an appointment, but since the international patient pays more ($11 instead of $6), she can see the doctor when he arrives. There are so many places available that they would have to wait longer to get an appointment. Patient satisfaction is an issue here due to the long hours of waiting...half the paper...facilitated to make it profitable. While an MRI scan costs $1000 and up, this price must offset the employee cost, facility cost, administrative cost, maintenance cost and variable costs associated with it. Getting back to the point of use, the Certificate of Need Act stopped the underutilization of hospitals. The closure of hospitals, if it occurs, will lead to excessive use of hospitals resulting in reduced costs. However in Turkey, when they heard there was underutilization of hospitals, they invited medical tourism to fill the gaps (although I feel it's too late for the US). This is an article I found on India's secret to low healthcare costs. http://blogs.hbr.org/2013/10/indias-secret-to-low-cost-health-care/ Works Cited http://blogs.hbr.org/2013/10/indias-secret-to- low-healthcare-costs/