GoKawiilThe American Healthcare Conundrum
The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year.
This project finds it, one issue at a time. Each issue identifies one fixable problem, quantifies the waste from primary federal data, and recommends a specific policy fix. All code is open-source. Anyone can reproduce the analysis.
Subscribe on Substack | MIT License | Contributing
Savings Identified So Far
# Issue Savings Key Finding Data Source 1 OTC Drug Overspending $0.6B/yr Medicare pays Rx prices for drugs you can buy off the shelf CMS Part D 2023 2 The Same Pill, A Different Price $25.0B/yr US pays 7–581x more than peer nations for the same drugs CMS Part D, NHS Tariff, RAND 3 The 254% Problem $73.0B/yr Commercial insurers pay 254% of Medicare for identical hospital procedures CMS HCRIS, RAND 5.1 Running Total $98.6B/yr 3.3% of the $3T gap
The Core Finding
The same operations. Exposed to the same clinical evidence. Wildly different prices.
Source: iFHP International Health Cost Comparison 2024–2025. Prices are median insurer-paid amounts.
Published Issues
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