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

Updated 5 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 9:45 p.m. ET: 19,282,972 — Total deaths: 718,851 — Total recoveries — 11,671,491Map.
  2. U.S.: Total confirmed cases as of 9:45 p.m. ET: 4,937,441 — Total deaths: 161,248 — Total recoveries: 1,623,870 — Total tests: 60,415,558Map.
  3. Politics: Trump says he's prepared to sign executive orders on coronavirus aid.
  4. Education: Cuomo says all New York schools can reopen for in-person learning.
  5. Public health: Surgeon general urges flu shots to prevent "double whammy" with coronavirus — Massachusetts pauses reopening after uptick in coronavirus cases.
  6. World: Africa records over 1 million coronavirus cases — Gates Foundation puts $150 million behind coronavirus vaccine production.

Warren and Clinton to speak on same night of Democratic convention

(Photos: Abdulhamid Hosbas/Anadolu Agency via Getty Images, Sean Rayford/Getty Images)

Sen. Elizabeth Warren and Hillary Clinton both are slated to speak on the Wednesday of the Democratic convention — Aug. 19 — four sources familiar with the planning told Axios.

Why it matters: That's the same night Joe Biden's running mate (to be revealed next week) will address the nation. Clinton and Warren represent two of the most influential wise-women of Democratic politics with the potential to turn out millions of establishment and progressive voters in November.

Trump considering order on pre-existing condition protections, which already exist

Photo: Jim Watson/AFP via Getty Images

President Trump announced on Friday he will pursue an executive order requiring insurance companies to cover pre-existing conditions, something that is already law.

Why it matters: The Affordable Care Act already requires insurers to cover pre-existing conditions. The Trump administration is currently arguing in a case before the Supreme Court to strike down that very law — including its pre-existing condition protections.