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JAMA has an issue largely devoted to differences in healthcare spending between the US and (mostly) European countries. But you don't have to read the whole thing because an editorial summarizes the high points. First, the wastage is NOT ending up in physician pockets. While the US does pay physicians about twice as much as other countries, we have about half the number of docs per capita. The really big differences in spending come from things that are both high price and high volume (read: drugs, surgical procedures, and fancy imaging...we see you screening prostate MRI). Oh, and we also spend a ton on administrative costs. TBL: When it comes to the US healthcare system, it's not a buncha businessmen. It's a business, man.