Why Are American Health Care Costs So High?

In which John discusses the complicated reasons why the United States spends so much more on health care than any other country in the world, and along the way reveals some surprising information, including that Americans spend more of their tax dollars on public health care than people in Canada, the UK, or Australia. Who's at fault? Insurance companies? Drug companies? Malpractice lawyers? Hospitals? Or is it more complicated than a simple blame game? (Hint: It's that one.)

This is the first part in what will be a periodic series on health care costs and reforms leading up to the introduction of the Affordable Care Act, aka Obamacare, in 2014.

[WiolciaMrozowska]

The exorbitant cost of healthcare in America is a result of several complex factors. Firstly, the country's fragmented healthcare system leads to inefficiencies and administrative overheads, with multiple layers of bureaucracy and paperwork increasing expenses. Additionally, the high prices of medical services, pharmaceuticals, and equipment contribute significantly to healthcare costs, fueled by a lack of price transparency and competition. Moreover, the prevalence of costly medical procedures, defensive medicine practices, and a fee-for-service payment model further drive up expenses. Addressing these systemic issues and promoting reforms focused on efficiency, affordability, and accessibility is crucial to mitigate the burden of healthcare costs on individuals and the economy.

[cbekaroglu]

I am a healthcare economist, and I am not sure what your profession is, but every single thing you said in this video is CORRECT. It sums it up all very nicely and it is actually fun to watch. Thank you for the effort!

[jwhite]

Nine years later and this is still a huge issue...coming from someone who just had a small bone spur removed from my foot in an out-patient procedure and they apparently billed my insurance company for $27, 000. Thankfully I have insurance but I still have to pay a few thousand of that.

[Dee-jpek]

I never understood medicinal commercials. Are they expecting me to watch it and be all 'hey that looks neat, I can't wait for my next heart attack!'

[shinemperor]

As a Canadian with many member of my family having been through healthcare here in Canada I can say with pride, that our system works. It isn't perfect, but it does work quite well.

I've had my grandmother treated for her heart, an aunt with cancer, an uncle with an ruptured ulcer and much more in reasonable and in some cases very little time.

My sister had a stroke at 27. A stroke, that would have crippled her financially if she had it in the United States. In fact, the cost of the MRI's, the neurological specialist, the stays at a blood clinic to stabilize her PT/INR would have put her in poverty. To this day, every time I have to wait a few(sometimes up to 8) hours in the hospital for something, I remember that if it wasn't for the single payer system we have here, my sister would have had more than just a stroke to recover from.

Today she is fully recovered and works two jobs, one full time and the other part time (she's trying to become a teacher). She NEVER complains about taxes... why? Because they make a difference. Also, she works in healthcare as well. The single payer system isn't perfect, but it protects people and is a step forward in creating a more equitable and compassionate society.

[zooeyhall]

"American health care is expensive because people go to the doctor too much". That's one that really ticks me off. The overwhelming majority of people will not go to see a doctor unless they truly feel sick. After all, how many people actually look forward to being admitted to a hospital? Not unless they have to go!

[bigd]

When I got into a car wreck a few years ago, my ER visit was $8k, paid for by my insurance. and all they did was a CT scan and gave me some pain meds. I couldn't imagine not having insurance and needing to go to the ER. This made me really feel bad for people who don't have health insurance.

[elityre]

"The truth, as usual, is complex."

[Waterbuoyed]

Anecdote: My wife, an American who came to Canada for Med School (and stayed), had a conversation with the administrator of her 1000+ bed teaching hospital. He had hosted a conference of Hospital CEO's and was touring them around. A US administrator at one point asked where his 'billing department' was.
He pointed out someone (Madge or something) behind a partition.
The US administrator was gobsmacked. His billing department occupied an entire floor of his hospital.

[GDKira]

in the UK we pay upfront more for watching TV than for Healthcare

[frankontaneda]

watching in 2019 and still so relevant

[mortalkaiban]

And everyone wonders why we fear going to the hospital. BECAUSE OF THE BILL..

[frantic]

Some say "we've got the BEST health care in the world!"   But what good is that?  If people can't afford to use it?

[adelaidemarie]

I need to get some wax removed from my ear. It is impacted. I have no insurance. The cost of removing wax? $150.00 Is The cheapest but can't get in till January. There is a doctor who will do it next week but he charges $285.00
Looks like I'll be crossing the border into mexico where I can have it done for $20.00

[sigiluvsu]

This was my first ever vlogbrohers video :) I watched it because as a kiwi, I couldn't understand why the USA had such inefficiency and poor outcomes. 7 years and a global pandemic later, the contrast in healthcare is wider and more deleterious than ever before. I am so grateful for how our centralised system and robust free care has allowed us to present a united front to one of the biggest healthcare challenges we have faced.

[asherujudo]

I have seen several videos, read a crapload of articles and listened to politicians debate this issue for years but this is literally the first time I have ever truly understood it.

[pugfugly]

Wait, marketing? Your healthcare system spends money on marketing? Like... "Come to our hospital, we have cookies" kind of marketing? Wtf?

[mimiHTcat]

us: pays a lot in taxes, doesn't get health care in return
uk: pays less taxes and gets free health care
logic???

[healthcareforallhawaii]

Great video. I wonder if you've covered the costs of micromanagement of physicians? 35% of health care spending in the USA is on admin costs, and the 'pay per value' system of physician reimbursement is how most of that occurs. Switching to 'pay per time' in a single payer system helps to wipe out 80% of our current admin costs.

[johnchessant]

7 years later and the only proposed fix to our healthcare system that can plausibly address the problems of inadequate price negotiation and bureaucratic inefficiencies (the two biggest problems mentioned in the video, by cost) is still regularly called 'unrealistic'