Cost is high but quality is low--why the paradox?

Implications: While cost per capita is the highest in the world, why is our quality substandard?--Health care status is not solely based on healthcare and rejection of accountability of American people remains prevelant. More money is NOT the answer to what ails us in health care.

Analysis:  I appreciate Mr. Manheims more eloquent explanation of why the unit cost in America is twice our nearest Westernized country yet rates #40 in quality (did not explain).  I believe until the model of competition changes from pain by consumers, our system will remain misdirected and overpriced.  I concur that use of benefit design is the best cost control mechanism today given the mental mind set of Americans--who seem oblivious to all the scientific work by major universities showing major flaws and no accountability with the quality of care given to Americans.  Oversight of quality is regarded as an intrusion between physician and patient yet most respectable MCOs have physicians asking via evidence based medicine reasonable questions--"will this service change your course of therapy or help the outcome of the patient." 

Our American's understanding of our health status is linked almost solely with our health care delivery system--this is far from reality.  One can have the best bar none health care system yet poor population health.  I would suggest instead of pouring more money into an over technologically oriented and abused system by stakeholders to issues of behavioral patterns, genetics, environmental exposures, and even social status/environment.  I suspect Americans suffer from too much inappropriate health care and not enough assessment and focus on their own behavior, e.g. smoking, obesity, and inactivity.  Our inner city issues require a very multi-focus approach.  Until this happens, cost control will be leveraged by benefit elimination by payers by necessity.