Why do we have such costly health care, and is this commensurate with the value received?

1-Why do we have such costly health care, and is this commensurate with the value received? What drives our health care costs and how can we control or reduce them while maintaining or increasing value?
2-What are the advantages and the disadvantages of comparative effectiveness research (CER)? Should the US implement a CE effort? How is the US doing as far as major recent developments affecting quality care, and providing incentive for quality care?