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The most expensive health care system in the world.

The United States spends more on health care than any of the world's other affluent democracies combined. Through all of this investment, the United States' life expectancy is lower than that of its peers. Furthermore, many Americans are unable to afford health insurance.

A Bloomberg “Prognosis” podcast from January 9, 2020 looked at some of the reasons why health care in the United States is so much more expensive than in other nations. The podcast included interviews with two Harvard T.H. Chan School of Public Health experts: Austin Frakt, senior research scientist in the Department of Health Policy and Management, and Ashish Jha, K.T. Li Professor of Global Health.

One reason for high health care costs in the U.S. is that the country never set limits on payments for new treatments, such as MRIs, organ transplants, or new drugs. “Other countries responded by putting in brakes into the system,” said Jha—but the U.S. didn’t.

Another driver of increased costs is that the health care system got more complicated, with insurance companies requiring patients, doctors, and hospitals to work harder to prove that particular treatments are necessary.

“Behind the scenes, there is a large army of people overseeing how the hospital and doctors will be billed for those services,” Frakt said. And this is complicated further by the fact that how they are paid is determined by our own insurance. Often, my insurance is not the same as yours.”

“There is a vast army of people behind the scenes monitoring how the hospital and doctors will be paid for such services,” Frakt said. This is complicated even further by the fact that our own insurance determines how they are paid. My insurance isn't quite the same as yours.”

Listen to the “Prognosis” podcast: Yes, the U.S. Health-Care System Is Broken. But It Doesn’t Have to Be

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Ashish Jha Austin Frakt Global Health K.T. Li U.S.


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