Note, the only formula we will be addressing today in total expenditure is the value of quantity periods. I think I have tried to argue that quantity is not the big reason for higher spending. And so that leaves just one other element, the cost. … Let’s speak of it. Is the cost the problem? And we’re going to come back to what I mean by price. So, there’s one issue: are the prices?
Let me just make the other argument before I get to the particular substances that other people have looked at substance use. Were we taking more medicines than any other country? It turns out that we don’t; actually, we’re on average. Yes, the French tend to take more drugs than almost anyone else. But we’re on the high side on some issues, there were some things on the low side. Approximately 80 percent of the U.S. prescriptions are for generics.
I think doctor’s salaries are a complex issue, and it’s a complex issue because almost nobody — no other country — has doctors graduating with significant medical debt. And if you pay for medical care, which counts not so much in health spending, but education expenditure. It leads to the earlier question of someone, are you comparing apples to apples in terms of what counts? But the bottom line is that medical debt in the U.S. is significantly higher than almost anywhere else. Length of learning tends to be much longer here, particularly for a lot of specialty physicians.
These are the questions that people ask, right? Those are the people thinking about the tradeoffs. And it turns out that in almost every sector we pay our professionals more. Our top lawyers are paying more than France’s top lawyers. On average, our engineers are paying more than France or Germany or the UK engineers.