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It's easy to criticize the U.S. health care system for high spending and poor outcomes, but American patients may also be the problem, the Atlantic's David Freedman writes.

What's happening: One study found that 74% of the variation in life expectancy within the U.S. was attributable to lifestyle factors like smoking and inactivity — behaviors decided by patients, not doctors. And American patients don't like to be told they can't have expensive care, using more speciality care and emergency care than other countries.

  • A survey of 1,000 patients recently found that only 31% view cost as very important when making a health care decision.
  • Other countries often exclude expensive, unproven treatments from health coverage, but "when American insurance companies try this approach, they invariably run into a buzz saw of public outrage," Freedman writes.

The bottom line: Americans are often over-treated, but doctors say that's because patients demand it — and that they fear malpractice lawsuits.

  • And then there are patients who disregard what their doctors say — like failing to take their prescribed medication.

Go deeper: Drug pricing's "double whammy" for patients with chronic illnesses

Go deeper

Caitlin Owens, author of Vitals
1 hour ago - Health

Who benefits from Biden's move to reopen ACA enrollment

Photo: Chip Somodevilla/Getty Images

Nearly 15 million Americans who are currently uninsured are eligible for coverage on the Affordable Care Act marketplaces, and more than half of them would qualify for subsidies, according to a new Kaiser Family Foundation brief.

Why it matters: President Biden is expected to announce today that he'll be reopening the marketplaces for a special enrollment period from Feb. 15 to May 15, but getting a significant number of people to sign up for coverage will likely require targeted outreach.

2 hours ago - Technology

Big Tech bolts politics

Illustration: Eniola Odetunde/Axios

Big Tech fed politics. Then it bled politics. Now it wants to be dead to politics. 

Why it matters: The social platforms that profited massively on politics and free speech suddenly want a way out — or at least a way to hide until the heat cools. 

Felix Salmon, author of Capital
2 hours ago - Economy & Business

GameStop as a metaphor

Illustration: Aïda Amer/Axios

A half-forgotten and unprofitable videogame retailer is, bizarrely and incredibly, on the lips of the nation. That's because the GameStop story touches on economic and cultural forces that affect everyone, whether they own a single share of stock or not.

Why it matters: In most Wall Street fights, the broader public doesn't have a rooting interest. This one — where a group of small traders won a multi-billion-dollar bet against giant hedge funds by buying stock in GameStop — is different.