Dollars vs Death Why the US Pays the Most for the Worst Results

Don DeRosa

Alright, welcome back to Expert Real Estate Secrets. I’m Don DeRosa, and I’m here with Mia. Today, we’re stepping a little outside our usual real estate lane, but trust me, this is a topic that hits home for every investor, homeowner, and, well, just about anyone living in the U.S. Mia, you wanna kick us off with the big numbers?

Mia Arnold

Yeah, Don, these numbers are wild. So, the U.S. spends about $12,914 per person on healthcare. That’s 18.3% of our entire GDP—just on healthcare. And when you compare that to other developed countries, we’re spending almost double, but here’s the kicker: we’re not getting better results. In fact, we’re dead last in life expectancy and avoidable deaths among our peers. I mean, I had a friend who went to the ER for a sprained ankle—nothing major—and she got a bill for $2,500. She thought it was a mistake! But nope, that’s just how it goes here.

Don DeRosa

Yeah, and that’s not even an outlier. It’s the norm. We’re pouring money into this system, but somehow, we’re sicker, we die younger, and we’re living with more chronic disease than just about anyone else in the developed world. It’s like, where’s all that money actually going?

Mia Arnold

And that’s the thing, Don. It’s not like we’re getting more care for all that spending. We don’t have more hospital beds, we’re not seeing doctors more often, and we’re definitely not spending more time with them. What we do have is a lot more waste—like, administrative costs eat up about 25 to 30 percent of all healthcare spending. That’s just paperwork, billing, insurance wrangling, all that stuff.

Don DeRosa

And don’t forget about drug prices. Prescription meds here cost way more than anywhere else. Plus, we’re doing all these expensive interventions—sometimes stuff that doesn’t even lead to better outcomes. I actually worked with a seller once who had what they thought was “good insurance.” But after a medical emergency, they ended up in bankruptcy. The bills just kept coming, and the insurance company kept finding ways not to pay. It’s heartbreaking, and it’s not rare.

Mia Arnold

That’s the real fallout, right? It’s not just numbers on a spreadsheet. It’s people losing their homes, their savings, their peace of mind. And it’s all because the system is set up to reward complexity and billing, not actual health.

Don DeRosa

So, let’s talk about why it’s so complicated. We’ve got private insurers, public plans like Medicare and Medicaid, and then all these out-of-pocket expenses. There’s no national price standard, so you could get an MRI for $400 in one place and $3,500 in another—same machine, same scan. It’s just chaos.

Mia Arnold

And when you look at countries like France, Germany, Australia—they’ve got universal coverage, they negotiate prices centrally, and they have actual controls on what things cost. Their systems are just less fragmented, and it shows in the results. People get care when they need it, and the whole thing runs smoother.

Don DeRosa

Yeah, but I mean, do you think we could just copy what they’re doing? Or do we need to tweak it for the U.S.? I feel like there’s always this argument that “it wouldn’t work here,” but honestly, what we’ve got now isn’t working either.

Mia Arnold

Right, and I think it’s about learning from what works elsewhere, but also being real about our own challenges. We can’t just import a system, but we can definitely take some notes.

Mia Arnold

One of the biggest things we’re missing is prevention. The U.S. system just doesn’t invest in preventive care or managing chronic diseases. We wait until people are really sick, and then we spend a fortune trying to fix things that could’ve been managed earlier.

Don DeRosa

Yeah, and if you look at places like Japan, they’re all about early detection and lifestyle interventions. They catch stuff before it gets expensive. That’s a huge reason their costs are lower and their outcomes are better.

Mia Arnold

So, what could we do here? I mean, we could start by making preventive services a core part of primary care—like, fund it properly, make it easy for people to access, and run public health campaigns that actually reach people. Policy reforms, funding shifts, all that. It’s not rocket science, but it does take commitment.

Don DeRosa

And then there’s the equity piece. Socioeconomic disparities in the U.S. are huge. If you’re low-income, or you live in a rural area, or you’re part of a marginalized group, your odds of getting good care drop way down. That’s not the case in a lot of other countries with more equitable systems.

Mia Arnold

Yeah, and there are real policy levers we could pull—like expanding Medicaid, increasing subsidies, and investing in underserved communities. There are programs out there that have made a difference, like community health centers and mobile clinics. We just need to scale them up and make them sustainable.

Don DeRosa

It’s like, we know what works. We just have to actually do it, and make sure the funding and political will are there to back it up.

Mia Arnold

Let’s talk tech for a second. There’s so much potential in things like electronic health records and telemedicine. If we could get everyone on the same page, it’d cut down on paperwork, reduce errors, and make care way more coordinated.

Don DeRosa

And then there’s value-based payment models—paying for results, not just for doing more stuff. That’s how you get providers to focus on what actually works, not just what pays the most. Plus, if we had real transparency in pricing and quality, people could actually shop around and make informed choices. Right now, it’s like flying blind.

Mia Arnold

Exactly. It’s about empowering consumers, but also making sure the system is set up to reward quality, not just quantity.

Don DeRosa

So, how do we actually build something better? I think it starts with collaboration—public and private sectors working together to innovate and cut costs. We need nationwide health literacy campaigns, too, so people actually understand their options and how to stay healthy.

Mia Arnold

And we can’t ignore the social side of health. Things like housing, food, and education all play a role. If we fund pilot programs that bring those pieces into primary care, we can start to address the root causes of health disparities, not just the symptoms.

Don DeRosa

Yeah, it’s about seeing the big picture. Health isn’t just what happens in a doctor’s office—it’s everything around us.

Mia Arnold

Last thing—if we really want to fix this, we’ve gotta change the incentives. Pay providers for keeping people healthy, not just for doing more procedures. Bundled payments, accountable care organizations, all that good stuff.

Don DeRosa

And let’s not forget education. We need to teach people how to navigate the system, understand their bills, and make smart choices. That starts young—partnering with schools and community groups to build health literacy from the ground up.

Mia Arnold

Totally. If we can get people comfortable with this stuff early, we’ll have a generation that’s not just healthier, but also way more empowered. Alright, Don, I think that’s a good place to wrap for today. This is a huge topic, and we’re just scratching the surface, but we’ll keep digging in future episodes.

Don DeRosa

Absolutely. Thanks for hanging out with us, everyone. Mia, always a pleasure. We’ll see you next time on Expert Real Estate Secrets. Take care!

Mia Arnold

Bye, Don! Bye, everyone—stay healthy out there.