>My meaning was that the traditional soundbites about market economics (Walmart etc) don't work for healthcare.
Of course economics applies.
Our former system had all the problems any econ 101 class could predict from a quasi-socialist system.
Shield consumers from the real cost, and they over-consume.
Shield consumers from the real cost, and they demand the best of the best.

>I agree it's the systemic bloat that drives up prices, but then you have to explain why it's more prevalent in the US if that's the explanation for the greater cost.

Our lawyers, and absence of the loser-pays rule at law are a big part of it.
Entitlement mentality of US consumers whether insured, on the dole, or just indigent explains the rest.

>FWIW, when I trained it was regarded as a moral expectation to be parsimonious, to protect the public purse.
I agree that is the ethical stance.
A US patient has every right to sue if he is not given the best of the best care, cost be damned.
A US doctor cannot be parsimonious.

The point of the kidney stone episode was that third party payment is a powerful disincentive to parsimony.
My costs when fully insured were 15 TIMES greater.

My guess is that if I had been treated by a doctor trained as you suggest, I would have been sent home with orders to drink many gallons of water to see if that fixed the problem. In fact, in that case, that was the exact cure. Even the cash-price MRI could have been safely foregone. However, with the constant threat of being sued, my Nurse Practitioner had no choice but to order the test.