• Edited by: Atif Zafar, MD

The 3 Reasons Keeping The US Healthcare System Crazy Expensive?

Why Is The US Healthcare Brutally Expensive?



My two cents: The US Healthcare system promotes diagnostic testing to a level which is mostly excessive.


For every 100 tests, we probably catch a a couple of real pathology that would have been otherwise missed in healthcare systems in the UK and Canada. (Numbers made for the sake of example)


A 21 year old being told that her low back pain is nothing serious will linger with that pain in the UK and Canada, whilst she will get an MRI Lumbar spine in the US pretty early in the pain cycle. May be 2 in a 100 will have a pathology of sorts that requires radiculopathy surgery or some sort of intervention beyond physio and pills.


These 2 cases among a 100 will positively reinforce a culture of ordering MRI spine in the other 998 patients in the US, whose MRI reports will come back negative. For these other (with negative MRI results) 98 patients, the UK and Canadian Healthcare systems actually did just fine where they probably did lumbar x-rays if needed.


Why did we, in the US, order more MRIs then? Are we more aggressive or more empathetic? Or are we more scared due to the malpractice sword hanging on our neck? Or are we carelessly wasting resources? Or do we believe that even if a 1000 MRIs are needed to give a higher quality care to those 2 folks who got timely discectomy, so be it?


More questions than answers. Pharma profiteering, insurance system biases, healthcare middlemen and wastes are well established concerns that raise the cost as well. Hard to fix.


I call and am advocating for the #3keys to fixing US Healthcare.



The #3keys are:

1. Too many diagnostics,

2. Too few goals of care discussions, &

3. Too many malpractice suits.


Optimize workflow and legislate in these 3 areas. Focus on the #3keys and you will see Healthcare become more affordable. More manageable.


Otherwise with recession and the state of US economy and aging population, we are staring into a healthcare abyss.



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Atif Zafar, MD is a physician, entrepreneur, and the author of the book "Why Doctors Need To Be Leaders". He is a physician leader with experience in both the US and Canadian healthcare systems.


As a leader in healthcare, he is interested in simplifying the business of healthcare for the customers (patients).

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