Six of the 10 most expensive places to buy health care in the nation are in Louisiana, including Metairie, Baton Rouge and Lafayette. That's according to a new Institute of Medicine study that attempted to examine geographic differences in health care spending among Medicare, Medicaid, privately insured and uninsured populations. Monroe, Alexandria, and Shreveport also make the list behind No. 1 ranked Miami and No. 2 ranked McAllen, Texas, based on Medicare spending data. With Louisiana near the top of many of the country's "worst of" health lists — asthma, diabetes, heart disease, obesity — it could be tempting to credit this distinction to our state's particularly unhealthy population.