Compare the differences between the Japanese and United States Health Care System.
The Japanese diet. Check
The lack of obesity in Japan. Check.
The lack of violent crime. Check.
The lack of lawyers? What?
Defensive medicine is expensive Is it irrational? Yes. But so are the standards of care that have been established and perpetrated not by rational evidence based medicine but rather by fear of the lawsuit.
Let me give you an example. What if evidence based guidelines argued against ordering a CT angiogram of the chest in a patient on room air with a normal d-dimer who complains of shortness of breath.
Now what if the standard of care in your community, a standard established out of fear of being sued, said that all patients with shortness of breath get a CT scan of their chest, regardless of the oxygen levels or d-dimer level.
The lawyer could sue that one doctor who doesn't order a CT scan based on evidence based guidelines because the local standard does not operate on the evidence. It operates on the standard of care which was established by irrational fear based medicine.
Now you can understand why every patient gets a heart cath. Every patient gets a colonoscopy. Every patient gets an EEG. Every patient gets that liver spot biopsied or that lung spot biopsied. Every patient gets their heart valve replaced or their gallbladder taken out.
Because nobody wants to get sued for doing nothing. It's a lot easier to defend yourself in court when you say everyone else is doing everything and that's what I did, than it is to say the evidence says to do nothing, even though my local community standard is to do everything.
And that's why the Japanese are cheaper
