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Health care is a pretty simple one to explain. In addition to the fact that technology doesn't bring massive productivity increases to a field that requires human-to-human interaction, the fact is that health care today is a much much more extensive undertaking than it was 50 years ago. We have much better drugs, much better treatments, and much better diagnosing tools. There's also the paradox that better health care means longer lifespans which means greater health care expenses. When chronic conditions can be managed instead of quickly becoming terminal, that's a win, but it also means that the health care costs for that human go way way up. There's corruption, rent-seeking, patent abuse and monopoly effects, too, of course, not to mention a balkanized health insurance market. But the basic fact is that we get a lot more from health care industry than we ever did in the past, so you'd expect that that portion of the economy would be much bigger than it ever was.


Plus a large portion of the public in America doesn't pay for healthcare directly (they either get employer-based health insurance or declare bankruptcy) so it distorts incentives while retaining the profit motive. Furthermore American society is seemingly setup to avoid exercise and healthy foods at any cost.

The Japanese are just as wealthy, older, and they smoke more, but they have better health outcomes and they spend almost a third per capita on healthcare. Chile spends about a ninth on healthcare and their average life expectancy is a full year more than the USA.

On top of all of this is the fact that people can get into debt at 1% interest. Hard to be cost-conscious when dear old gran needs a $20k (only $50 per month!) treatment to live another three months. Same thing happened to education.


Key part about that distortion is that it hides the rent seeking.


The rent seeking of drug companies and over-regulation?


Forgive me, I'm unclear how we went from insurance company malfeasance to regulatory capture by Big Pharma.


Interesting theory about corporation style bureaucracy taking over public (governmental) functions, leading to increased costs, among other side effects:

"The Utopia of Rules: On Technology, Stupidity, and the Secret Joys of Bureaucracy"

by David Graeber

http://amzn.to/2mi169U

Same economist who wrote Debt.

First theory for why public education has gotten so nutty. Like requiring K-12 teachers to have masters degrees and ongoing training (out of pocket) while paying them peanuts.

Frankly, this book blew my mind.


Does anyone know a writer 50 years ago predicting the cost disease in U.S. healthcare? If not, "you'd expect" seems like hindsight. The closest I can think of is science fiction stories about a corporation monopolizing a genuine immortality treatment, which is both infinitely beyond 2017 medicine and just one of many sf scenarios.


So why, in this view, did U.S. life expectancy decline recently? http://www.npr.org/sections/health-shots/2016/12/08/50466760...


Alright, but many other nations get as much from healthcare as the USA does, while paying much less for it. Examples: western Europe, Canada, Japan.




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