The recent House Ways and Means Committee hearing reflected something larger than frustration with hospital pricing. It exposed a growing recognition that decades of effort trying to reform healthcare have produced mounting cost, rising dissatisfaction and little confidence that the current model can deliver results.

Healthcare leaders should stop treating reform as a debate about who is to blame and start focusing on why meaningful change has repeatedly stalled and what needs to be done differently. Understanding those barriers is essential to building a more accountable system.