Eliminating Wasteful Health Care Spending—Is the United States Simply Spinning Its Wheels?

The United States is the most expensive health care system in the world,¹ with broad consensus among experts that a considerable portion of that health care spending is wasteful. In 2012, Berwick and Hackbarth² estimated that, at minimum, wasteful spending accounted for 21% of total expenditures in the United States. Since its publication, the United States has experimented with several new payment models, hoping to spur innovations that will curb unnecessary and wasteful health care spending. In a study in a recent issue of JAMA, Shrank and colleagues³ took another look at how much progress we have made. Overall, the results are disappointing.