Wasteful Expenditures in the United States Healthcare System:
Identifying Inefficiencies and Opportunities for Improvement
Abstract
Rationale: The United States has one of the highest healthcare
expenditures among developed nations despite performing poorly on health
metrics and access to care. Wasteful healthcare expenditures in the US
not only affect patients but also have broader implications for public
health. Aims and objectives: To identify major sources that
contribute to wasteful spending in the US healthcare system.
Method: A comprehensive literature search was conducted to
identify relevant studies on wasteful expenditures burdening the US
healthcare system. Search terms such as “wasteful expenditures,”
“healthcare costs,” and “inefficiencies in US healthcare” were used
in PubMed and Google Scholar databases. Full-text peer-reviewed
articles, reports, internet articles, and policy documents were included
in the study. Studies published in languages other than English were
excluded. No ethical approval was required for this review as the
analysis was conducted on previously published literature.
Results: Approximately a third of US healthcare spending is
considered wasteful. According to the Institute of Medicine, excess
costs have been associated with unnecessary services, inefficient
delivery of services, high service prices, excessive administrative
costs, low emphasis on prevention, and fraud. Other factors that were
identified to affect the healthcare experience for patients included
insurance payment denials, high out-of-pocket expenses, and
administrative complexities. Overcoming these aspects might result in
annual savings that can range up to $282 billion. Additionally, the US
has greater preventable and treatable mortality rates than other nations
due to increasing chronic diseases, emphasizing the need for greater
utility of preventive and primary care services. Despite the ACA’s
intention to include preventive services in health plans, obstacles
persist in their consistent integration across states.
Conclusion: In summary, improving access to care by increasing
affordability and prioritizing preventive care services can
substantially reduce unnecessary costs to the US healthcare system.