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Why do patients behave this manner by which? The reimbursement structure of our healthcare system provided incentives to do more. Doctors are paid piecemeal. Execute a procedure, receive sponsorship money. We get paid for quantity and volume not quality. To be a result, patients fall in the trap believing that getting more is better care a great deal fact research indicates Americans have more spent on healthcare per capita than any industrialized country ever and yet we rank dead last on health outcomes.