Why Are American Health Care Costs So High?

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In which John discusses the complicated reasons why the United States spends so much more on health care than any other country in the world, and along the way reveals some surprising information, including that Americans spend more of their tax dollars on public health care than people in Canada, the UK, or Australia. Who’s at fault? Insurance companies? Drug companies? Malpractice lawyers? Hospitals? Or is it more complicated than a simple blame game? (Hint: It’s that one.)

For a much more thorough examination of health care expenses in America, I recommend this series at The Incidental Economist: http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/
The Commonwealth Fund’s Study of Health Care Prices in the US: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/May/1595_Squires_explaining_high_hlt_care_spending_intl_brief.pdf
Some of the stats in this video also come from this New York Times story: http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=all

This is the first part in what will be a periodic series on health care costs and reforms leading up to the introduction of the Affordable Care Act, aka Obamacare, in 2014.


vlogbrothers says:

+John Green discusses the complicated reasons why the United States spends
so much more on health care than any other country in the world, and along
the way reveals some surprising information, including that Americans spend
more of their tax dollars on public health care than people in Canada, the
UK, or Australia. Who’s at fault? Insurance companies? Drug companies?
Malpractice lawyers? Hospitals? Or is it more complicated than a simple
blame game? (Hint: It’s that one.)

Why Are American Health Care Costs So High?

Marutan Ray says:

the solution is … communism. it was not implemented right ever so far.
just go communist and people willl become healthy and they will not visit
the doctor who will not treat and will not prescribe the medicine which is
unavailable in the pharmacy and so …. very few people will visit the
doctor which reduces the cost.

ThaDrag IV says:

So America is stupid?

pugfugly1989 says:

Wait, marketing? Your healthcare system spends money on marketing? Like…
“Come to our hospital, we have cookies” kind of marketing? Wtf?

Milan V says:

The important thing is that US has the biggest military budget in the world
by far, so they can, well, you know, bomb Middle East n shit, yeah, you
know, ‘Merica.

chris spray says:

1. Profit motive. Health care providers want to make money not provide
health care.

2. Market disfunction. Means health care providers can overcharge and
patients have little or no recourse.

3. Corruption. Weak regulation and politicians on the take means the market
disfunction won’t get corrected.

These three points can be illustrated by $10,000 toilet seat for the B2
bomber. It’s a toilet seat, but it costs $10,000. 

regfadfagrafdzcv says:

I had an ambulance ride it cost 5,000 dollars after they padded the bill
with all kinds of stuff I didnt even want or ask for

Ryukachoo says:

what about the incredibly amount of money the us spends (collectively) on
it seems like most medical research comes out of the US, and the high costs
are meant to cover those R&D costs
….and then of course china steals the formula and sells it for cheap

Khongor Shatar says:

Americans have so large population, high taxes but have no free health

SinnedNogara says:

I ended up in the hospital and a CT scan cost 6000 dollars. Can someone
explain this shit?

Rodrigo Colimodio says:

Explanation: extreme and pure capitalism. (Do not get me wrong, I agree
with capitalism, but that extreme as happens in the United States, is It is
terrible for society and the people). for example: I am studying civil
engineering free like others hundred of thousand of students, thanks to
State finances our universities… (sfmbe)

Otávio Toledo says:

John >>> Hank

Oh yes

manzilla48 says:

Why are Americans so against Obamacare. In the uk you can get your health
care for free. This means healthcare is very accessible and not too

The Coffee Nut says:

No wonder congress doesn’t want to fix healthcare. THey get it for free
while we get screwed. 

Evan Marshall says:

Because it is a healthcare day…and Republicans are still trying to keep
our “best healthcare in the world” system (which is actually #37 in the
world) the “best”…e.g. keep it #37 or lower….and by far the most
expensive in the entire world with zero better healthcare outcomes.


Sean Petrash says:

This is silly. He mentions that medicare negotiates for the bottom dollar
and then fails to state that medicare takes up over 30% of the entire
federal budget. Medicaid being the other 30%.
He should stick to history. 

Jake B says:

The estimated annual health care costs of obesity-related illness are a
staggering $190.2 billion or nearly 21% of annual medical spending in the
United States. Childhood obesity alone is responsible for $14 billion in
direct medical costs.

UT DO says:

The real question is: why doesn’t the free market do it’s job here?
competition should push prices down isn’t it ?

Charles Hagen says:

Why Are American Health Care Costs So High?

Benedocta says:

1:42 The US is not richer per capita than Switzerland. Just saying.

flatchested20 says:

does obamacare raise it at all or no…and ive heard social security
medicare and medicaid account for 40% of our spending yet we dont do basic
things like increase the age you get certain things even as the average
life expectancy increases

are any of these true and is there anything politicians can do to lower
cost or no

Lloyd Franklin says:

Asthma Inhaler in the US costs $120 while the same inhaler in Cuba costs 5

Michael Beard says:

I wanted to say “all in a nutshell”, but it was a little more than that.
Think he hit it on the head? And don’t give my any crap about Affordable
Health Care Act”. We’ve had this same since way before Obama got into
office. Now we just need to find a way to start fixing it.

David Provencher says:

almost 6.5 million watched…how about you…yah! you


Che Marshall says:

Two young men I work with – perfectly healthy young men – have on several
occasions gone rushing into the emergency room Monday morning to be
diagnosed with hangovers. Yes, hangovers. Apparently the fact that Monday
is the first day following their weekly two day binges never occurred to
My only point is the mentality. I grew up too poor to go to the hospital
unless it was a legitimate emergency, or dire concern. But, being as
wealthy as we are as a nation, many people don’t have that mentality, many
people will rush directly to the hospital at the first sign of even mild

Jim Oliver says:

Our corrupt politicians collude with providers to keep prices high.

Lucas Santos says:

In Brazil our public and free health care service sucks, and we pay one of
the highest taxes in the world >.< by the way, almost very thing here sucks!!! I’m not saying that because I’m actually “poor”, but because really sucks. The problems here are very complex, and people try to “simplify” too. I’m getting out from here as soon as I can, probably Australia…

Ania D says:

I think the amount of money that goes into the entertainment industry –
which is by far the biggest in the world – and the military is definitely
also a contributor versus the amount that goes into health care and the
fact that the population of the US is larger than the combined populations
of Canada, the UK and France, but of course this is a multifaceted issue.

JiveDadson says:

I am sad. I know Hank from science stuff. After hearing this polemic for
socialism I will never see him in the same light.

BTW, mik1984 nailed it. Search the comments.


America pays more for taxes because we have to support A HUGE MILITARY
which spends more than the rest of the world combined or close to it at

Mosinlogan says:

Well. We could have better healthcare but we would have to cut down on the
military spending. But maybe if the rest of the world would help us with
things like ISIS among other world issues. 

Stacy Adams says:

what all does john green do besides crash coarse?

Sam Tom says:

The biggest single drag on the American economy is the copper/zinc penny

james p says:

2 many big word

itsazy says:

Wait so how did he come to the conclusion that the lack of centralised
planning/purchasing was the problem?

Nathan Clevenger says:

Obama care is slavery at it’s finest! I don’t need nor want health care but
i’m either fined at the end of the year or required to carry a overpriced
policy that I don’t need to not be fined. Land of the free my ass. 

Bonnie Hundley says:

He’s always so caffeinated! Ha ha. La la la. 

Stefaan Jacobs says:

There are just in my opinion some things you as a country’s
government obligated to do for your people,. education, and healthcare, are
some of those things.

Christopher Sadlowski says:

$124 dollars for Lipitor. Sprycel, which is my treatment for Chronic
Myeloid Leukemia, is $10,000 A MONTH. I WISH I only had to pay a little
over $100 bucks for my prescription. Oh, and by the way, I have to take
that medicine to keep me alive FOR THE REST OF MY LIFE which is anticipated
to be relatively normal. It costs me, on one drug alone, $120,000 a year.
That’s the annual salary for some rich people. Ugh, holy shit, I wish the
government got their act together, stopped listening to these stupid
lobbyists, and get our health care fixed! I honestly think “they” want the
chronically ill to drop dead…that way we’d not be a “problem” anymore.

Frank Mitchell says:

Somehow I got snared into a discussion of the ACA health care with a guy
who claimed “America has the best health care in the world” and twisted
every statement I made into support for his position.

FWIW, most of what I know about health care in the U.S. and other countries
is in this video. I’ve gleaned some other stuff from the news (and BBC
programming) but this summarizes most of it.

Also FWIW, I still maintain the ACA (a.k.a. Obamacare, a.k.a. Romneycare
before he ran for president) is on the whole a slight improvement but props
up a broken system based on private insurance and runaway costs. Other
countries systems have their own problems, but if I were a betting man I’d
wager that few if any people in those countries have to choose between
buying medication and paying bills.

Michael Tarnpoll says:

f drug and insurance companies were not allowed to participate, via
lobbying and actual inclusion in the process, in creating the legislation
that constrains their industries, costs in the US would be comparable to
those of other advanced countries. The problem and the cause, is corruption
founded in the usual: greed.

rockshot100 says:

Cost are not high enough. The only way to break up this monopoly is to deny
coverage to Congress and other “public servants”. Things would change

Francesco Varrato says:

Why Are American Health Care Costs So High?: http://youtu.be/qSjGouBmo0M

warriorprince101010 says:

The US government set up a healthcare system that funnels tax payers
money towards their friends insurance companies and Pharmaceuticals.


Philip McNiel says:

I think a lot of the issue is control. There’s an age-old saying that goes
like this: “He who pays the bills, makes the rules.” Americans don’t want
to give the government the power to set arbitrary limits on their
healthcare, such as saying that any cancer patient with a chance of
survival of 5% or less can no longer get treatment (as is done, I’m told,
in Britain). We’ve just heard too many American-style stories of people
who either beat the odds, or were mistakenly assigned such low odds in the
first place.

Also, there is a way in which healthcare is most certainly an industry.
I’m talking about the sense of the word “industry” that means “hard work.”
It takes hard work to become a medical professional. If you want to become
a doctor, here’s how it works here in the USA: You work hard for four
years, trying your absolute hardest to get your best grades while staying
involved in extracurriculars, then go take an extremely difficult test
called the Medical College Admissions Test (MCAT). Maybe you even take a
specialized MCAT prep course. Then, once you’ve gotten into med school (IF
you make it), your hard work is only beginning. If you choose to become a
specialist, you may find that by the time you’re finished with your
training, you’ve cut off the first EIGHT TO TEN YEARS of your adult earning
career when compared with your peers who went into other industries.
They’ve graduated, got jobs, married, started families, and here you are
just getting out of college and starting at the entry level in your
career. OF COURSE you want to get paid well, to make up for lost time and
for lots of hard work in medical school for which you were not paid at the

If you want to become another type of medical professional, you won’t spend
as long in school, but you’ll still have to take lots of classes that would
be considered “hard” by the average college student’s standards, such as
anatomy and physiology, organic chemistry, and the like. People sacrifice
quite a bit to become the highly-trained pros we have here in the USA, and
the Law of Supply says that the only way to have a good supply of people
who are willing to walk this road is to pay them well.

Alan Sirk says:

Excellent post. Poignant and succinct. I would also like to add an
observation. Perhaps one of the reasons why all of this occurs in the land
of the free is that Americans are in general accepting of the idea that
healthcare, like anything else should follow a regular business model.
Unfortunately, the goal of any business is to make money and this has
nothing to do with creating a healthy populace. “Keep the government’s
hands off my healthcare”! You are right, much better to put decisions
about what products or procedures I may be reimbursed for to be put in the
hands of a private corporation that would lose money by paying for them.
Any government (which would actually benefit from having a healthy
populace financially) would be less likely to have my interests in mind?
Please. “The government is so inefficient that It would become even more
expensive”! You think? I doubt it, but would be willing to take the
chance just the same. Even if it did, if it meant that everyone had equal
and adequate coverage, I would be OK with it. Who says the government
can’t “lose” money on healthcare (at least in the short run)? Perhaps that
is another idiosyncrasy of Americans, people who don’t work for it, don’t
deserve coverage. Of course, they themselves may be one illness away from
losing their own homes, but that would never happen to them!

Henry Hürden says:

LOL. USA is richer than austria? I don’t think so.

Christina West says:

I’m one of those impoverished Americans who can’t afford health insurance,
and can’t stay on my parent’s plan because I don’t have parents. I also
live in infamous Oklahoma, so my governor banned my opportunity to get
assistance for that. If it weren’t for two emergency room visits, I would
have died twice.

So, sorry guys. You’re paying for the fact that I’m still alive, twice.

DukeTRF says:

Holy shit I like your style of ranting 

Jamil Chaya says:

The fundamental issue, not mentioned in this video which is by and large
causing many of the “problems” brought up in this video is the idea of
aggregated versus disaggregated insurance schemes. Insurance costs reflect
the expected financial toll of the average “insuree” and as the pool of the
insured grows, the expected average expense shrinks to some steady state
reflected by the state of the world at that time. In short, there are
certain endeavours which we know now benefit enormously from economies of
scale and insurance is one of them. Comparing the prices per capita may be
flawed but the gaps between nations is not so simply explained by things
costing more which is largely done away with currency equivalence… 

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