Good read, I'm at work and don't have time to read the final section just yet, but I will when I get a chance. He seems to understand the broader problems with American politics, although why he is so optimistic that they can be overcome outside of "civil unrest" I'm not sure.
More specifically, his account of the care he received in the ER is disturbingly accurate in many ways. The ER doctors and other staff are intentionally left rather poorly informed with regard to the financial side of things and are frankly trained to completely disregard such factors lest it compromise the care they provide or have an affect on their decision-making outside of the patient's well-being. They are required by law to treat any patient who presents to the ER, and even though the actual degree of "emergency" of the patients' conditions varies wildly, they're all given the same "emergent" care, with relative priority given to the higher acuity patients. The hospital has collectors that come around from room to room to inform patients about approximate costs and to find out what they will be willing to pay and when (often the answers are "nothing" and "never"). These people are the only ones who will directly address anything of a financial nature while the patient is in the hospital.
The same medications, treatments, and other costs incurred in an ER--versus some primary care facility or something--are billed at obscenely high rates. Some of the biggest obstacles to remedying this are all the middle men like billing companies, management companies, insurance companies, etc. And the ER doctors are usually contractors rather than direct employees of the hospital (whether this is the same for nurses I don't know), which adds another layer of insulation between the actual services provided and the fees being charged.
-J