Perhaps the USA spends more on healthcare because there are so many opportunistic individuals and insureds out there that want to get "their money's worth", even if they aren't paying for it? Perhaps another reason is all of the latest and greatest medical devices, machines, or whatever that we seem to demand?
There is a HUGE number of people involved in the billing and collection of medical bills. Even in Medicare, there are some ins and outs of coverages and codes, by observation. If the coding might not be done correctly or misinterpreted, it CAN lead to large expenses which the insured has to pay.
It has seemed strange how far behind the billing can be from when the office visit took place. It also seems like "a waste" to send the insured a bill for 92 cents for the part of the office visit or procedure that Medicare or the insurance company didn't cover. If you've been there, you can relate, I suspect, by observation.
And then you have doctors who might not release their patients to go back to work as soon as they might. Or order tests that might not be really needed, other than to ensure the lastest test is current and done to their specs. Some of these things might be driven by malpractice issues, but some also seem to be driven "by opportunity". with all due respect.
Our USA system might have many inefficiencies or ballooned costs in it, but to fix it would require a complete culture change for many in that industry AND for the insureds. It seems that every time I hear a radio show extolling the virtues of socialized medicine or how much better the Canadian system might be, I also hear about many other things which are not as good as our system is and THOSE things will matter to a whole lot of people in the USA.
It has become a system driven by PPOs and such, which negotiate their rates with the doctors. If you are a doctor and need business, you'll probably become aligned with one of the PPO systems. In those systems, all doctors now seem to be "generic" with one being as good as another, it seems, as reliance upon the licensing board to do their job is where the buck gets passed to rather than a physician's personal knowledge of another physician's medical background, experience, or demeanor.
Regards,
C-BODY