American medicine has built a system where finding the answer quickly can be less valuable than keeping the patient inside the system. I know how provocative that sounds. We are talking about an industry entrusted with the most consequential purchase most people will ever make: keeping themselves and their families alive.
Yet the financial architecture of American medicine often rewards activity, procedures, and billable complexity. The patient wants resolution. The system has learned to monetize the journey.
Look at the scale of the machine. The United States spent $5.3 trillion on healthcare in 2024, equal to 18 percent of the entire economy. Hospital spending reached $1.63 trillion.
Physician and clinical services accounted for another $1.11 trillion. Out-of-pocket spending alone reached $557 billion. Yet, when I look around us, it begs the question: What are we paying all that money to accomplish?
A patient does not wake up hoping for six appointments, three billing departments, a prior authorization battle, and another test six weeks later. They want the right scan, the right diagnosis, the right treatment and the shortest reasonable path back to their lives. I learned how broken that incentive can feel through my own son’s care.
A scan was performed incorrectly, yet the financial burden did not disappear with the mistake. We were still left paying for the encounter and facing the prospect of returning to do it again. Imagine ordering a $20 pizza, receiving the wrong one, and being told you need to pay another $20 because the restaurant made the mistake.
Extract — continue reading at the source.
