> Health care has been a focus of the financiers because it accounts for 18% of gross domestic product in the United States.

This seems extremely high.. Ireland with free public healthcare for example is ~6%.. I think the largest in Europe, by a lot, is Germany? ~13%.

People assert all sorts of nonsense in response to questions like this, usually not at all backed up by the data. The drivers of high US healthcare costs are:

  1. Doctors, nurses, and hospital admins make dramatically, *dramatically* more money in the US than anywhere except Switzerland. Every time a discussion of healthcare costs comes up, everyone tries to point their fingers at middlemen, but the middlemen extract tiny fractions of the revenue stream. Most of it goes to actual humans that are high status, and no one wants to imply they’re lobbying to lower the pay of these folks

  2. The US pays for drug development for the entire world. You can call this the US “overpaying”, or the rest of the world “free-loading”, but the US is a very rich country that has decided to incentivize drug development by allowing drug companies to profit from their massive investments by setting high prices

  3. Americans are fatter than the rest of the rich world (although the rest of the rich world is rapidly catching up) and chronic metabolic-disease is very expensive to treat (everywhere)

There are definitely things in the system that drive prices up (like lack of competition (see CON) and middle men). However, a big reason you see this high cost and difference between countries is Baumol cost disease. Productivity and salaries in the US are very high. Meanwhile healthcare, like education for example, has seen very low productivity improvements. This leads to an ever increasing price. It's unintuitive because the healthcare workers didn't get more productive. However, they could be more productive elsewhere, so comp needs to go up to stay competitive with other options available to the workers. One might argue that nurses for example still earn very little, given how hard and important their work is but that's precisely what you'd see in areas affected by Baumol. The comp only gets dragged up to keep people from quitting or striking. There is little to no competition for something like a "10x nurse" because that's not a thing and the industry struggles to keep justifying their high prices while TV prices keep dropping and dropping and cellphones keep getting more impressive.

The problem is that it's an inelastic market. So sellers can basically charge WHATEVER they want, constrained only to the line where people will revolt. But that's a very high line in the US.

Health providing shouldn't be a for-profit endeavor. Certainly shouldn't be in the stock market and it absolutely shouldn't be comingled with "insurance"

Part of it is that Americans consume a lot more healthcare than other countries. They take more medication. They take more cutting edge medication (e.g. it's rare GLP-1 agonists to be used for weight loss outside the US). They see more therapists and chiropractors. They are more likely to stay in private hospital rooms.

Much of this is heavily subsidized by insurance. Any drastic change in the status quo would inevitably cause pricing and coverage that people are used to be adjusted, which is why they say they want healthcare reform until it actually happens.

US healthcare expenditures are ludicrously high, because the US healthcare “system” is ludicrously inefficient by global standards.

US public healthcare expenditures are similar to what some developed countries with fully public universal healthcare have—and the private expenditures on top are more than the public costs.

People sometimes joke about the US having gaps in healthcare because of defense or other spending, but the fact is the US effectively pays vast amounts of money to create those gaps, rather than having them because of some resource constraints.

There is a lot of skimming at multiple levels. Far too many middle layers and gatekeepers, constantly haggling and looking for more ways to profit. Continuous market consolidation to fewer players looking to exploit economies of scale over decades. Perverse incentives everywhere.

There are still people trying to behave ethically within this framework, but it's hard when the framework itself is so corrupted by profit motives which should never have been there in the first place. Direct providers should be running the show, not financiers. They need to be aware of how to balance the books within reason and be paid properly, but beyond that it should be much more patient focused. We definitely don't need so many profit-taking leeches in all the places we have them now.

It's not high considering how much more it costs to get medical care in the USA and the poor efforts by insurance companies and health care in general for pre-emptive care, also US in general is not as healthy as the other Western Nations, where that fault lies I'm not sure (self or general availability of care).

Fun fact: Public healthcare spending in the USA is at about 7% of GDP between Medicare, Medicaid, and military healthcare. The US governments spend more on healthcare as a percentage of GDP than many countries spend giving it to everyone.