While sniffing out a Commonwealth Study on cancer statistics that the WSJ referenced but CW never released, I came across a pretty good paper on the actual causes for the insanely high US health prices. Generally, folks trying to justify the fact that we spend like Paris Hilton on a bender tend to fall back on a couple theories: 1) Medical malpractice, and the "defensive medicine" bogeyman; 2) rationing in other countries.

The studies authors take both theories and riddle them with birdshot. Average malpractice awards domestically are lower than in Canada, the UK, or Australia (has it occurred to anyone else that if there is indeed an epidemic of defensive medicine -- which I don't believe, but nevertheless -- that the fault probably lies on conservative-created hysteria about malpractice awards and American litigiousness?), and the whole malpractice "industry" amounts to less than one half of one percent of spending (for a very comprehensive takedown of all aspects of the medical malpractice myth, go here). That's just not the stuff our health spending is made of.

As for supply constraints, the researchers checked out the 15 procedures that account for the bulk of wait times in foreign lands. They make up 3 percent of our total spending. In addition, health spending in the twelve countries with waiting lists was $2,366 per capita. In the seven without, it was $2,696 per capita. In America, it was $5,267 per capita. So sorry, no answers there, either.

And to burst another bubble, we don't get more resources than folks in other countries. Indeed, our per capita hospital beds, CT scanners, physicians and nurses were lower than the OECD average. Ouch.

The authors conclude, at this point, predictably, that prices of care account for the difference. And why shouldn't they? With no centralized bargaining authority to demand deals on common technologies and procedures, why should providers negotiate with a fractured system that has no choice but to buy their products and why should the fractured system unify when they can just keep passing costs along to businesses and consumers? The Medicare Part D mess is just our failed system writ small, the whole explained in the part.