In the practice of medicine, recognizing and assessing symptoms is vitally important. But to make the patient better, a doctor must accurately diagnose and treat the disease.

This is also true for the nation’s costly healthcare system.

At a hearing in Hartford Monday, citizens and their elected leaders rightly expressed concern over the steep rate increases sought by health insurance companies in the state. The insurers are asking the Connecticut Insurance Department to approve the increases for 2023. These insurers provide individual and small-group insurance plans through Connecticut’s Affordable Care Act Exchange, and also offer policies outside the exchange.

Some of these rate hikes do appear excessive, averaging 20.4% for individual health plans. The insurance department should take a hard look at the justifications offered for the proposed increases, which vary depending on the policy. Greed is one factor that makes U.S. healthcare costs the highest in the world. If excessive profits are behind these requests, state insurance officials need to trim them back.

However, the ever-higher cost of providing healthcare in this country is just a symptom of the disease. And that disease will remain even if consumer advocates are successful in curtailing the proposed rate hikes. In fact, drawing too stringent a line on rate increases could prove counterproductive by driving health insurers off the exchange, limiting both competition and options for consumers. Three insurers sell policies on Connecticut’s exchange: CTCare Benefits; ConnectiCare Insurance Company; and Anthem Health Plans.

The approval of the Affordable Care Act significantly improved access to health insurance coverage in the country, but it has not been successful in controlling costs. Those costs, and the resulting high premiums, leave many unable or unwilling to buy insurance, with about 10% of U.S. residents lacking coverage. The uninsured rate is 6.3% in Connecticut.

Yet as the nation prepares for the 2022 election, there is little debate about lowering the high cost of medicine. Our elected leaders can begin by attacking excessive administrative costs. These costs account for about for 34% of health expenses in the United States, unmatched in the developed world and twice the percent spent on administration in neighboring Canada.

Excessive amounts of money are spent on medical bureaucracies from claim-submission experts, to managing the arcane discipline that is medical-record coding, to overseeing payment systems that vary depending on the institution and the type of insurance coverage, or the lack thereof.

Congress could help by demanding greater standardization and by mandating that electronic medical records be shared between institutions. As things stand now, healthcare networks make it problematic for patients to move from one network to another for care, including by making electronic record interchange difficult.

U.S. healthcare is also costly because there is too much testing. This is driven by several factors. These include the lack of communication between medical providers, so that tests and examinations are repeated. Also playing a part is defensive medicine. Ordering every possible imaging analysis and blood test can preclude a personal injury attorney from faulting a doctor or hospital for failing to do so. Finally, this equipment is expensive, and hospitals need a return on investment. Per capita, the U.S. has four times the number of MRIs than does Canada, yet there is no evidence of that leading to a lack of care for Canadians or improved care for Americans.

Reforms to limit malpractice exposure, regulation to control an excessive amount of testing equipment and the associated costs, and requiring improved and modernized communication could all help drive down these costs.

Excessive price increases for some medicines also must be addressed. Congress, or at least the Democratic majority, took a step in that direction by passing a law that will allow the negotiation of some drug prices paid through Medicare.

We don’t disregard the efforts by elected leaders and consumer advocates to climb atop their soapboxes and decry the requested health insurance rate increases. But more than 12 years after passage of the Affordable Care Act, it is time for both major political parties to offer serious proposals for addressing the high and forever-rising cost of healthcare.

The Day editorial board meets with political, business and community leaders to formulate editorial viewpoints. It is composed of President and Publisher Timothy Dwyer, Executive Editor Izaskun E. Larraneta, Owen Poole, copy editor, and Lisa McGinley, retired deputy managing editor. The board operates independently from The Day newsroom.