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Editorial
October 7, 2019

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

Author Affiliations
  • 1Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Department of Medicine, Harvard Medical School, Boston, Massachusetts
  • 4Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
JAMA Cardiol. Published online October 7, 2019. doi:10.1001/jamacardio.2019.4339

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.

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