Your claim here, were you to try to make it, would have to be that American doctors are across the board 2-3x better than European doctors, and that European pts are getting drastically fewer procedures than they need.
Specifically for doctors, that seems a reasonable point or question. I know intimately from my PhD studies that some procedures performed widely in the US aren't that effective (meniscectomies in particular). Though that's gotta be balanced with procedures that are helpful that Europeans don't do enough.
More broadly though, I believe what's occurring with doctors is also happening across the board in other professions. Landlords as an aggregate are charging more than if fair, and the median landlord isn't a billionaire or Blackrock but probably part of the professional managerial class (PMC) [1]. No idea if landlords as a whole are charging 25% or 250% more for rent, but rent seems to have outpaced inflation by a fair bit.
Similarly others here mention doctors owning portions of diagnostic imaging companies who go on to request unnecessary imaging. That's the PMC enrich-yourself-first mindset. Historically it was the local landed nobles.
Repeat that across more fields and professions and you see that the middle and lower classes will be squeezed much more by PMCs than by billionaires, IMO. For example, it'll be some VP at Google who's pushing to raise the cost of YouTube premium rather than Sergey Brin or the Youtube CEO. Another VP who's figuring out how to move software to a never-ending subscription, etc. Though it'd be hard to split out the effect of say PMC's vs corporate profiteering. Perhaps they are part of the same effect.
You know if the damn prices were not so hidden behind paperwork electronic or otherwise between the provider and insurance company, together with well disseminated facts about cost, and outcomes we could let market forces sort this out so poor service + high cost is mediated somewhat ...
Ideally the provider would bill the patient only without recourse to any insurer. The patient if satisfied could ask the insurance to pay. This way the bill "is out " in the sunlight, and providers have no way to get paid unless customers are happy. At bare bones it aligns provider with patient through a bill like anything else. Adversarial patients ... are another thing for later ... but i want people to start seeing US medicine up front rather that stuff that goes on behind the scenes.
I realize ppl get all kinds of paperwork now including sometimes bills ... but c'mon it's one thing if it's FYI after the fact" because it was all submitted to insurance yesterday anyway ... or ... this is it; the bill is due ... approve it ... or else ...
I mean, if the argument is that exogenous supply constraints are the root of most of our economic problems, and that the economy is rigged for the upper-middle class and the billionaires are just along for the ride, we probably share a lot of politics, but either way: my point on this thread is just: start with the total picture of where money in our system goes.
A lot of people think most of it is going to insurers and pharma companies, which is the literal opposite of what's happening.
Yeah agreed the issue with medical costs in the US isn’t primarily pharma or insurers.
It’s just easier to blame them companies because they’re more centralized. Easy to point and say “look at the billions in profit”. Doctors as a whole are likely make many billions more in profit but it’s harder to see and understand that.
(I think we agree though).