Why the US Healthcare System Is So Expensive, and What Can Actually Fix It episode artwork

EPISODE · Mar 20, 2026 · 31 MIN

Why the US Healthcare System Is So Expensive, and What Can Actually Fix It

from Overheard In The Emergency Room · host Dr Adrian Cois MD

She came in on the bus. An 84-year-old woman, independent antwenty years, wa her health for d diligent abouts sitting in my waiting room for four and a half hours with a blood pressure of 222 over 104. Her insurer had dropped her long-standing doctor. The next available appointmentwith a covered provider was five months away. She was on $60 a day. She couldn't afford to pay out of pocket. So her blood pressure medication lapsed.This is preventable. It happens every week. And it is a direct consequence of how the US healthcare system is structured.In this episode, Dr Cois — Emergency Physician and creator of drcois.com — breaks down why the US spends more on healthcare than any other nation and still ranks last on outcomes, and walks through three serious proposals to fix it: Medicare for All, the Trump Great Healthcare Plan, and the EMBRACE plan from Annals of Internal Medicine.In this episode:— Why the US pays $13,500 per person annually — twicepeer nations — for worse outcomes— Five structural drivers of cost: fragmentation,high prices, fee-for-service, the uninsured, and monopolisation— Medicare for All: the Lancet evidence, thetrade-offs, and the political barrier— The Great Healthcare Plan: what the KFF analysissays about what it leaves unanswered— EMBRACE: a tiered universal coverage model with anindependent governance board — and why it may be the most realistic pathforward— Three healthcare reform myths busted with evidence:physician pay, VA quality, and the free market track record— What you should do this week — clinically andpoliticallyThis is a Tier 1 issue. Pillar 5 of our blueprint,s that accessible. For too many Americans, it doesn't.Fewer bad days. More good decades.Companion blog post + full references at drcois.com

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Why the US Healthcare System Is So Expensive, and What Can Actually Fix It

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