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The U.S. has the worst patients in the world

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