Recently, I read an excellent book by Shannon Brownlee, “Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer.” Its thesis is that America spends more on health care as a percentage of our GNP (16%) than any nation on earth, yet we get less for it in terms of life expectancy and generally healthiness (Canada and France spend 10% and live longer).

More health care does NOT automatically equate to being healthier. “Overtreated” states that between “one fifth and one third” of health care dollars are spent on “care that does nothing to improve our health.”

Sooo…. how to spend less on health care while still staying healthy?

Solutions exist and they are laid out at the conclusion of the book. Some are relatively easy, such as ending incentives to over treat created by the one—two combination of fee-for-service compensation (vs. performance, results based) and fear of litigation.

Other choices are harder: Is it wise to spend such a huge percentage of health care dollars upon the last few months of life? Or upon risky or marginal treatments? How lavishly should we spend other people’s money on those who have lived risky lifestyles and harvested the resulting whirlwind? And it is always the other guy being over treated (the “I’m curious, you are nosy” syndrome of human perspective!).

Nonetheless, it is vital that America realize that when it comes to health care spending, more health care does not always lead to a healthier America.

This is a classic from the NSC Blog archive. Originally posted January 11, 2008.