We spend more on Health care because we rely on a Free Market System, rather than a centralized single payer system. Switzerland is right behind us in expenses because they also use Private Insurers.
Free Market systems cannot keep prices down when there is no elasticity in the demand for a product. If you raise the price of beef enough, people will switch to pork or chicken. But no sane person will do the Jack Benny trick of considering the options when the question is "Your money or your life?". Although people will economize somewhat on some healthcare decisions ( often resulting in expensive emergency room visits) there is no elasticity in the demand for health itself. Consequently, when the market decides the price, it goes up indefinitely. A single payer system is the only way of reversing this trend.
One Poster on a NYtimes comment page claimed that she had solved the health insurance problem by simply paying for a few checkups, and not getting health insurance at all. I replied to her thusly:
"Someday you will probably have a huge major medical expense, which will completely bankrupt you, and still leave thousands of dollars in extra debt that the rest of us will have to pay. You might escape being a free rider if you are "lucky" enough to die young from a quick violent death. But most people who follow your strategy will end up in the emergency room and stick the rest of us with the tab. Your strategy works for you only because you are free riding on those of us who have health insurance. It would not work if everybody else did it."
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