Near end of life procedures? A friend in health care told me 60% of one of our biggest hospital's costs go toward end of life (patient will die within weeks) treatments. Understandably, people request all the most expensive procedures because they don't want to let their loved ones go.

The answer is fairly simple if we look at the examples available to us - health metrics and spending per capita of of all other first world nations.

The answer seems to be universal single payer health care.

There are a wide variety of health care systems in other first world countries that are not single payer systems that don't have spending that is vastly higher than the countries that have single payer systems. For instance, Switzerland and the Netherlands both have mandatory private health insurance, similar to the way ACA was designed to work. Germany's system is based on a public option rather than being purely single payer.

I think instituting a single payer system in the US would be a good first step, but it is unlikely to completely solve our problems.