>>Yes, yes, you'll say.. but.. this is your health I'm talking about. Well, tripping over your shoe laces can be pretty damaging to your health, can't it? Maybe we should hire someone to check them after we've tied them and fill out forms in triplicate to prove that they've been checked and that I have been made aware of my privacy rights and that if I have a living will, blah blah blah.

Seems to me that replacing a hip is "slightly" different from tying your own shoe laces, especially in the litigious USA.

>>That's absurd, isn't it? Well, it took almost an hour for me to get a flu shot this year while someone filled out more paper than I knew existed in the town of Hamilton, New Jersey.
>>All for a poke in the arm. And all that nonsense increases the cost of the shot dramatically.
>>Then I had to acknowledge all the privacy nonsense.

Yes, but if the poke in the arm goes wrong, the ambulance chasers will swarm. The issue in the US is that there are lawyers whose income depends on picking through documentation with a fine tooth comb looking for any nit to try to claim grievance and a jackpot payout. So extensive documentation becomes necessary unless you want to be sued out of existence. In other jurisdictions you are correct that you can just walk in and have an immediate flu shot at a fraction of the cost, even in a booth outside a mall pharmacy.

>>I'm cynical enough to wonder if the difference might be that the person tying the shoe laces doesn't wear a white coat and is not being paid for the extra checking and double checking, the living will junk and the privacy crap so one good tug will therefore suffice.

Does your analogy still work if you sue yourself because you tripped over your own shoelaces? US lawyers are the fleas that will kill the healthcare host if allowed. E.g. Texas: just over a decade ago the litigious environment became so extreme that physicians began limiting their practice or leaving the state. Not everybody realizes that so many obstetricians quit Texas that access outside the main centers was little better than third world standard. Who would have believed it, in a land that prides itself on the best care in the world. Here's how they solved it: http://www.texmed.org/Template.aspx?id=27834 . Support tort reform in your own state and you'll soon see whether physicians are the ones driving all the cost and process. IME it's one of the burdens they resent the most.