To the editor: The article, “With healthcare, it’s not what you spend but how you spend it,” misses perhaps the three main reasons Americans spend too much on medical care.

First, doctors order too many tests that are unnecessary. In the rest of the world, doctors order what their training deems necessary, but in the United States, so many tests are ordered for liability purposes, and the costs are astronomical. They also lead to the discovery of new findings (“incidentalomas”), which begin even more testing and workups for unrelated and often benign conditions.

Second, Americans demand too much testing. CT scans may cost $900, as the article notes, and they are ordered here for just about everything. Any sprained ankle or upset stomach has the potential to lead to a CT scan, and often because the patient demands one.

Third, Americans spend incredible sums on end-of-life care. The cost to keep someone alive in his or her final six months is astronomical compared to the costs incurred before.


If Americans expect that level of care, then someone (actually everyone) will be expected to pay for it and not complain.

Robert Goldstone, MD, Corona del Mar

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To the editor: As an American consumer, I’ve long treated healthcare as a product, not a service.


The for-profit healthcare industry has loving, caring, very well-paid employees using the latest, most expensive diagnostics. Most importantly, the industry itself has high prices that are not explained by normal cost-of-living factors.

Simply put, good, old-fashioned American greed is at the root of this crisis. Demand is high, and supply is always in catch-up mode. Good luck fixing it.

Spike Tucker, Lompoc

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To the editor: Americans should compare their current healthcare system to those in other developed nations. While we get good healthcare here, studies don’t bear out that it is superior to countries having universal care.

Yes, it is true that some foreigners come to the United States for treatment. It is also true that many Americans seek treatment and prescription drugs abroad because of the cost savings.

With truly universal coverage, our taxes would go up. But if you consider our ever increasing insurance premiums and out-of-control prescription drug costs, it does not seem universal healthcare would cost us more than what we are paying now.

It has become clear we cannot depend on Congress to improve our healthcare system. In today’s political climate, would even Medicare and Social Security have become law? While it was challenging to get these passed, both programs have become very popular.


Perhaps it is time for us to think more about what is best for this country. With so many countries having universal coverage, surely we can find a model that would work for us.

Donna Staggs, Murrieta

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To the editor: American doctors being paid more than their international counterparts reflects the high cost of becoming a physician in the United States.


Here, many physicians are saddled with hundred of thousands of dollars in debt by the time they start practicing medicine. Medical education in other developed countries is heavily state-subsidized.

In the grand scheme of things, physician pay in the United States plays an extremely small part of the cost of medical care compared to drug and administrative costs.

Daniel Katz, Newport Beach

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