If that's in contradiction to us buying more healthcare, then we must admit that some of that healthcare isn't productive, it's rent seeking. IMO, this is what I actually see in the US, so it all adds up.
As an example, rich people getting lots of testing done increases spending, but it's driven by their wealth as much as it is by doctors enthusiastic to increase revenues. And if they are healthy, it isn't going to provide them much value.
Couple this with the attempts to centrally plan capacity and you get a cost spiral.
In a sanely administered system, you wouldn’t send every five year old that ran into some furniture to get a CAT scan. You’d just accept the infinitesimal risk of some hidden injury that couldn’t be caught with physical contact examination but could be caught with a CAT scan.
In another example, my wife’s grandmother had a stroke at 87. They medevacced her out of her house in rural Oregon to Portland. Then the doctors wanted to do a bunch of expensive procedures until she passed away a few days later. She was a lovely lady, but no European country would’ve greenlit these procedures on an 87 year old woman who had a quarter of her long missing due to lung cancer in her 60s.
The more you drill down into health indicators to distinguish the effect of medical care from other factors, the less it seems like US outcomes are worse. US overall indicators, like life expectancy, are worse. But those factor in many things that have nothing to do with the health system, such as homicide, car accidents, demographic, obesity, etc.
For example, Americans eat a truly disgusting amount of food compared to europeans. I’m a relatively low resource consumption asian, and even I was always hungry when we visited Paris because the portion sizes were so small.
Because it has the X-ray equipment, they have make a return on investment on it, and that's why they end up doing useless tests. Those are even harmful by the way, as X-rays are ionizing reaction, and useless CT scans are actually responsible for a non-negligible fraction of cancer in the US.
The reason why european countries don't run more CT scans isn't that they lack equipment, it's because the risk/benefit isn't good for cases like your son.
> In another example, my wife’s grandmother had a stroke at 87. They medevacced her out of her house in rural Oregon to Portland. Then the doctors wanted to do a bunch of expensive procedures until she passed away a few days later. She was a lovely lady, but no European country would’ve greenlit these procedures on an 87 year old woman who had a quarter of her long missing due to lung cancer in her 60s.
This is wrong. If we're sharing anecdotes let me tell you about my 97yo grand dad who's been admitted thrice in ER this year in France, and received what would have amounted to almost $100k of medical bills in the US. (He's OK now, but at this age you never fully recover to your previous state, so every trip to the hospital is a step down).
> The more you drill down into health indicators to distinguish the effect of medical care from other factors, the less it seems like US outcomes are worse. US overall indicators, like life expectancy, are worse. But those factor in many things that have nothing to do with the health system, such as homicide, car accidents, demographic, obesity, etc.
This is true, it explains a good fraction of the life expectancy difference, but it's irrelevant to the fact that the US pays twice are much for similar healthcare.
