That was mentioned at the very start of the 2nd link (see "superior good") and it's true virtually everywhere in the long run (especially in developed countries with reasonably reliable growth in disposable incomes and where we have pretty reliable data). If we want to identify systems that might allow us to contain costs on the margins knowing who spends least or the most is not informative in and of itself. Rather we should be interested in residuals with the best model, as in, who is furthest below trend (as a function of comprehensive consumption or disposable income), what plausibly explains this, and whether are we actually willing and able to implement those sorts of features in our system....

Incidentally these patterns are not only found in health care, the basket of goods has changed and continues to change as countries get richer: https://randomcriticalanalysis.wordpress.com/2017/05/09/towa...

It's his interpretation that people "chose" to spend more money as they got richer. Many other people interpret it differently, when the alternative to paying might be death.

Right, it's just a coincidence that disposable income correlates nearly perfectly with health expenditures at a national level in the long run (and quite well at a subnational level) and that when disposable income falls NHE tracks it and so on and so forth.

P.S., I wrote the blog post.

Perhaps that indicates how effective the healthcare industry in the US is at maximizing their revenue. If the choice is paying or dying, people will pay an unlimited amount.

Except the rich and poor spend pretty similarly in the US and elsewhere. The income elasticity > 1 occurs at a national level....

http://mason.gmu.edu/~rhanson/EC496/SOURCES/LUXURY.PDF

And the better data on price suggests US actually isn't unusually expensive for a high income country and so on and so forth. Much data points to higher volumes of health goods and services as we chase diminishing returns as a society.

I meant my comment about unlimited spending as an philosphical argument, not as a literal data point.

And yes, the biggest problem in the US is unneccessary tests, procedures, drug consumption, etc., and the cause of that problem is a system which is built around maximizing revenue instead of maximizing public health.

But if you look carefully you will find most of this behavior plays out similarly in those few countries with somewhat more comparable wealth (e.g., Norway). The issues that many people think of as being particularly "American" problems are problems that mostly have to do with our high material living conditions (as in, diminishing marginal utility attached to other forms of consumption and increasingly high values attached to human life). Overall health expenditures are increasing equally rapidly in these countries as a function of AIC, disposable income, etc and there is no evidence they are getting any more value for their money (having a healthier populations helps naive comparisons of life expectancy, IMR, etc a ton).

Here are some papers that touch on some of these more fundamental theoretical issues:

https://web.stanford.edu/~chadj/HallJones2007.pdf

http://mason.gmu.edu/~rhanson/showcare.pdf