This Brookings Institution report analyzes health care spending in the United States, reasons for excessive spending and ways to reduce spending without reducing welfare.

From the Report:

Much of the excess of U.S. spending is attributable to the fact that the unit prices of various services are higher in the United States than elsewhere. Some part of the high prices goes to incomes of highly trained personnel. But in some cases, such as outpatient services, much of the price difference goes to support inefficient production made possible by a lack of competition or effective regulation. High prices sometimes serve as a proxy for high quality— more or better equipment or better-trained personnel. We know of no hard evidence showing that the quality of high-price U.S. services is better than that of corresponding services elsewhere or whether and to what degree it accounts for higher U.S. prices. In some cases, however, price differences are so large (for example, magnetic resonance imaging studies in the United States and Japan) that no plausible quality difference can explain the gap.