According to the OECD, patients in the United States pay only 13% of their medical expenses out of pocket (as of 2005). This is equal to the United Kingdom, and less than Canada, both of which have (nominally) single-payer health care. The consequence of patients spending so little for their own health care is that our health “insurance” is really insulation. Consquently, patients over-consume by spending too much of other people’s money on ineffective medical care.
Case in point, the New Mexico Business Weekly reports:
The “Dartmouth Atlas of Health Care 2008,” a study released in April by the Dartmouth Institute for Health Policy & Clinical Practice, has shown dramatic regional differences in Medicare spending on chronically ill patients. The study went on to conclude that higher spending, more specialists and more days in the hospital do not mean better outcomes or better ongoing primary care.
The study found that patients with serious conditions who are treated aggressively for their illnesses don’t live longer or enjoy a better quality of life than those who receive more conservative treatment.
In an earlier publication, Dartmouth researchers found that
a large component of Medicare expenditures — $26 billion in 1996 dollars, or nearly 20 percent of total Medicare expenditures — appears to provide no benefit in terms of survival, nor is it likely that this extra spending improves the quality of life.
