A new study published in the Journal of the American Medical Association has revealed that the United States spends twice as much on health care as 10 other high-income nations, despite performing lower on a number of quality-of-care markers. Two recent articles — in The New York Times and The Washington Post — set out to find out why we seem to be paying so much more for less.

The study, which was conducted by a team of international researchers, compared nearly 100 measurements of care in some of the world’s richest countries: the United States, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, Denmark and the United Kingdom. Measurements were made between 2013 and 2016 and included both countries with single-payer systems and those with competitive private insurance markets.

Researchers found that overall, people in the United States spent about twice as much per person on health care as all of its wealthy counterparts. The study also showed that Americans appear to go to the hospital less often, have access to a smaller share of specialist physicians when they do get sick and typically have a lower life expectancy and higher infant mortality rates than their European and North American counterparts. 

The findings debunk the myth that in the United States, money is being thrown away on, for example, wasteful imaging scans, unnecessary prescriptions and preventable procedures. In fact, the JAMA report found that by and large, patients used the health care system equally across the study cohort.

So what’s to blame? The report cites higher doctor and nurse salaries, hospital charges, treatment costs and administrative overhead for the difference. For instance, in the United States, nonspecialist docs are paid an average of $220,000 per year — double the average income of their peers in other nations. Administrative costs also made up nearly 8 percent of total U.S. health care spending, compared with just 3 percent among other wealthy countries, which experts suggest is a side effect of our relatively complex and bureaucratic system.

Pharmaceutical spending in America was also higher, with U.S. patients spending an average of $1,443 per person on their medications. That said, Americans also had far more access to newer brand-name drugs than any residents of any other country.

As for reform, JAMA researchers say focusing more on the system and less on the activities of patients might be a good start. Until then, click here to find out how to lower medical costs during a cancer diagnosis.