Fixing U.S. health care was never going to be easy, but some persistent myths have made it more difficult than it should be. The first myth is that the system is failing. In reality, it is succeeding, but in an expensive way: Thanks to costly treatments, people are living longer. The problem is that, as a society, the U.S. doesn’t want to pay the premiums or taxes needed to support those treatments. Another myth is that costs can be brought under control by running health care more like a business and encouraging more competition. In America health care is already more commercial and competitive than it is anywhere else. Nonetheless, the costs there are the highest on earth, by far, and the quality of care is extremely uneven.

A version of this article appeared in the October 2011 issue of Harvard Business Review.