[artplumber]

You guys who think France is so great, fine. Go there. The WHO stats are a bunch of baloney. (I got healthcare in Europe and am in the industry in the US). The data are carefully engineered to eliminate the true benefits. Yeah, England had as good mortality data as the US during the NHS days, but you couldn't get a kidney after 55 (IIRC) or get started on dialysis after 70 (IIRC). A lot of this data also does not take into account the general health of the population. US BMI's were way higher than the continent. That is changing, and I bet that the real costs in Europe will soon start to mimic the US.

Some of this has to do with attitudes of the patients/families. In the US, often "pull out all the stops" is the attitude, where other cultures accept the inevitable.

We could always be like India/Hong Kong where if you can't pay, you don't get it. I have a friend who told me of families who watched their loved ones expire because they could not afford the treatment for easily treated diseases. But our country forces physicians and hospitals to work for free (once a patient is in the ambulance/ER they must be treated), and those patients are often the ones most likely to sue (afterall the hosp/doc are rich and can afford to give everyone $5 million, right?).

As to whether the cost of medicine is linear, as simplistically suggested elsewhere, it's not. 2x cost does not yield 2x benefit, especially when politics plays a role in reimbursement decisions. Most major mortality benefits for new classes of therapeutic agents for the major mortality diagnoses (coronary artery disease, stroke, cancers) are not giving huge benefits even though benefits are present. How does politics play a role? Screening for cancer is a great example. Routine colonoscopy is very expensive for population screening, and doesn't have a great yield. Yet, because it was promoted by someone with access to the public through widely dispersed medium (Katie Couric), suddenly it is a reimbursed procedure. Likewise, Oprah facilitated the emergence of coronary artery CT for screening. I can't wait until some exec getting routine CT's every year or two develops a leukemia and then wants to sue the scanner company (or Oprah) for radiation exposure induced cancer.

Then there is the whole defensive medicine aspect of doing tests to prove that certain things aren't going on in case providers are sued later on....