Tyler Cowen’s “Spending a lot on health care is the American way” (July 22) suggests our health care costs are so high because Americans consume health care the way wealthy people buy expensive cars, huge houses and other luxuries.

I think he’s blaming the victims (patients). Who goes to doctors and hospitals without a legitimate reason?

Mr. Cowan also claims that we shouldn’t see lower health care costs in other countries as a sign of their effectiveness. He doesn’t mention that along with our higher costs, American health care also has poorer results for patients.

Our health care is so expensive because we pay much more than other countries for the exact same drugs and medical supplies, have more unneeded tests and surgeries not resulting in better outcomes, have higher administrative costs due to multimillion-dollar executive salaries and paperwork from various insurance companies, and treat our uninsured in expensive emergency rooms because they can’t afford preventive doctor visits.

In his book “The Healing of America,” health care expert T.R. Reid notes that some countries have private providers but payment from government-run insurance that everyone pays into, similar to Medicare. “Since there’s no need for marketing, no financial motive to deny claims and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style for-profit insurance.”

Should America be the kind of country that lets sick people and those with chronic diseases such as diabetes, cancer, and heart disease die because they can’t afford to pay for insurance?

Ellen Field, New Gloucester