When an ACL costs $68k in California and $20k in Illinois and $32K in Delaware, you know that it's not an issue with simply the cost of getting medical training. Something else (I agree, something a lot more complicated than simply the cost of education or differencies in country-specific medical practices) is at work.
I think we actually agree here - the dramatic rise in health care costs doesn't have a single root cause, or even perhaps a readily identifiable root cause. It's systemic, rather than simplistic. Education is a factor, but a small one. Insurance and health liabilities are probably an equal factor. But neither explain disparities in cost within the US (no need to look at comparisons between Japan for that). See my [1] reference two comment posts up for the chart on cost disparities intra-US.
It's quite possible that medical suppliers are using information asymmetry to overcharge in some instances and properly charge in others. Could it be as simple as that? Why is it that the same procedure with the same equipment using similarly trained staff in similar hospitals with similar liability exposures would have such different costs? The only thing I can think of is that medical purchasing is sufficiently complex and with such little visibility and transparency between different establishments that medical suppliers and providers can get away with pricing them "as much as the market can support". But that's just an unsubstantiated theory and maybe there is a reason why the same procedure is cheaper in another state, county, or city.
It's difficult to see which factors are contributing without a similar breakdown for a similar procedure from somewhere else.
Are doctor's costs more expensive in CA due to the increased cost of living? Ditto for administrators, driving up the hospital costs? Is it due to a scarcity of hospital beds / operating tables that the hospital charges 'what the market will bear' in more densely populated regions?
I think we actually agree here - the dramatic rise in health care costs doesn't have a single root cause, or even perhaps a readily identifiable root cause. It's systemic, rather than simplistic. Education is a factor, but a small one. Insurance and health liabilities are probably an equal factor. But neither explain disparities in cost within the US (no need to look at comparisons between Japan for that). See my [1] reference two comment posts up for the chart on cost disparities intra-US.
It's quite possible that medical suppliers are using information asymmetry to overcharge in some instances and properly charge in others. Could it be as simple as that? Why is it that the same procedure with the same equipment using similarly trained staff in similar hospitals with similar liability exposures would have such different costs? The only thing I can think of is that medical purchasing is sufficiently complex and with such little visibility and transparency between different establishments that medical suppliers and providers can get away with pricing them "as much as the market can support". But that's just an unsubstantiated theory and maybe there is a reason why the same procedure is cheaper in another state, county, or city.