Though utilization in many areas mirrored other nations, administrative costs in the USA system dwarfed other countries. Health care accounts for nearly 18% of the U.S.'s GDP, compared to 9.6% to 12.4% in the other developed countries, the paper says.
Nor does America have too many high-paid specialists. "At least compared to peers, we have a pretty similar mix of primary care to specialists", Woskie said.
Jha said whether the U.S. moves toward more private healthcare, as advocated by Republicans, or to single-payer healthcare, as advocated by liberal Democrats, price tags on all American health services need to be addressed.
"We need to better understand why prices are so high and dive into that into much more detail, because some of the previous explanations may not actually be what's driving the U.S.'s spending", she said.
"In addition, the reasons for these substantially higher costs have been misunderstood: These data suggest that numerous policy efforts in the USA have not been truly evidence-based". The United States also has a higher rate of poverty and more obesity than any of the other countries, possible contributors to lower life expectancy that may not be explained by differences in health care delivery systems. Even after spending the huge amount, American had the lowest life expectancy rate and the high infant mortality rate in relation to other countries.
These costs are despite similar utilization rates for the US compared to the other nations.
But cost varied widely when it came to drugs.
Despite this, the United States still lags behind all other developed countries when it comes to the quality of said healthcare.
Americans also appear to pay more for diagnostic tests and office visits, Woskie said.
Researchers used 98 indicators to compare countries across seven areas: general spending, population health, structural capacity, utilization, pharmaceuticals, access and quality and equity. It's not necessarily that a lot of it is unnecessary, because our volume is similar.
"We know we spend a lot more than everyone else, and we have looked for easy explanations - things like greed in the system, fee-for-service medicine, overutilization", he said.
When it came to numerous measures of health system function, the United States was in the middle of the pack, not an outlier, as Dr. Jha had expected.
Maybe the United States health care system isn't that freaky after all.
That's not just because the United States has a complicated insurance setup, either.
Despite beliefs to the contrary, "the USA has lower rates of physician visits and days spent in the hospital than other nations", said the report.
The US also spends more on administrative costs.
"This work suggests that some of the more straightforward or simple solutions that have been posed are unlikely to address it in full", Woskie said.
The findings were published March 13 in the Journal of the American Medical Association. Administrative costs are 8% of total health spending in the US.
But Baicker cautioned that even this study can not provide a direct apples-to-apples comparison between countries, given variations in the way health care is provided between countries.
"Different health systems are producing very different outcomes, but one should have a note of caution in observing those differences and jumping immediately to a policy prescription, because policy prescriptions are going to require much more information about what's under the hood", Baicker said.
Any solution also will need to reflect the nation's morals and priorities, something that can not be assessed by pure economic analysis alone, she added.
Researchers also pointed out many myths regarding why U.S. health care is so pricey.