▁on ▁the ▁National ▁Register ▁of ▁Historic ▁Places ▁in ▁Kentucky ▁Category : Pop ulated ▁places ▁established ▁in ▁the ▁ 1 8 5 0 s ▁Category : 1 8 5 0 s ▁establish ments ▁in ▁Kentucky ▁Category : National ▁Register ▁of ▁Historic ▁Places ▁in ▁Louis ville , ▁Kentucky <0x0A> </s> ▁Un necess ary ▁health ▁care ▁( over util ization , ▁over use , ▁or ▁over tre at ment ) ▁is ▁health ▁care ▁provided ▁with ▁a ▁higher ▁volume ▁or ▁cost ▁than ▁is ▁appropriate . ▁In ▁the ▁United ▁States , ▁where ▁health ▁care ▁costs ▁are ▁the ▁highest ▁as ▁a ▁percentage ▁of ▁G DP , ▁over use ▁was ▁the ▁pre domin ant ▁factor ▁in ▁its ▁exp ense , ▁account ing ▁for ▁about ▁a ▁third ▁of ▁its ▁health ▁care ▁sp ending ▁($ 7 5 0 ▁billion ▁out ▁of ▁$ 2 . 6 ▁tr ill ion ) ▁in ▁ 2 0 1 2 . ▁ ▁Fact ors ▁that ▁drive ▁over use ▁include ▁pay ing ▁health ▁profession als ▁more ▁to ▁do ▁more ▁( fe e - for - service ), ▁def ensive ▁medicine ▁to ▁protect ▁against ▁lit ig ious ness , ▁and ▁ins ulation ▁from ▁price ▁sens itivity ▁in ▁instances ▁where ▁the ▁consumer ▁is ▁not ▁the ▁p ayer — the ▁patient ▁receives ▁goods ▁and ▁services ▁but ▁ins urance ▁pays ▁for ▁them ▁( wh ether ▁public ▁ins urance , ▁private , ▁or ▁both ). ▁Such ▁factors ▁leave ▁many ▁actors ▁in ▁the ▁system ▁( do ctors , ▁patients , ▁ph arma ce ut ical ▁companies , ▁device ▁manufact ur ers ) ▁with ▁in