Medicine is filled with good people doing the best they can to operate in a bad system. In my experience, most people in the health care industry are doing their jobs well. They just don’t realize that their job descriptions are just plain wrong.

In the U.S., we spend 2.7 trillion dollars per year on health care. Elsewhere, the average health care expenditure is $3,000 per person per year. In the U.S., it’s $8,000 per person per year. We spend more than $300 billion per year on pharmaceuticals, almost as much as the whole rest of the world combined. Yet our life expectancy is ranked at #50 in world. 49 countries are more successful at living long healthy lives than we are, and they do it at a lesser cost to boot.

Dartmouth University even did a study examining regional differences in how much it costs to care for a Medicare patient. They found that Medicare patients in Miami averaged a cost of $15,000 per patient per year, whereas Medicare patients in Minneapolis averaged about $7,000 per patient per year. The patients in Miami were getting significantly more medical care, and many more Medicare dollars were spent, yet the Miami patients did not have better outcomes and actually were more likely to die sooner than the Minneapolis patients.

20% of patients take up 80% of health care dollars, usually from chronic illness, repetitive hospitalization, and morbid obesity, yet this increased spending of health care dollars doesn’t improve the life expectancy of these patients. 

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