We Broke It. We Know It. And We Keep Paying for It Anyway.
$14,885 per person. Last among 12 wealthy nations in health outcomes. We know why. We just haven't fixed it.
INSIDE THE LOOP // ISSUE 04
By the time you finish reading this sentence, somewhere in a U.S. hospital, a preventable medication error is happening. The statistics say roughly one person will die from one before you get to the end of this article. You paid $14,885 per person last year for this. Switzerland, the second-highest spender in the world, paid $9,963. Japan, with better outcomes, paid $5,200.
We are getting robbed. And the thief is us.
I retired from Becton Dickinson in 2019. Not because I gave up. Because I was tired of pushing a very heavy rock up a very resistant hill, and I needed to breathe.
I spent forty years inside the machine. Alaris. CareFusion. BD. I helped connect the first generation of hospital infusion pumps to the electronic medical record. I co-authored the standards that made device-to-EHR integration possible. I held the patents. I fought the internal battles. I watched the external ones. I know exactly what this industry looks like from both the inside of the executive suite and the inside of the ICU.
I know what it costs when we get it wrong.
And then, after five years of watching from a distance and growing quietly furious, I came back. Not to a job. To a problem I cannot let go of.
That is what this issue is about
The Number That Should Keep Every Hospital Executive Up at Night
Between 44,000 and 98,000 Americans die in hospitals each year from preventable medical errors. That is the peer-reviewed range, established by the IOM’s landmark “To Err Is Human” report [1] and consistently validated by subsequent research including work from Johns Hopkins [2] and StatPearls in 2024 [3]. The upper estimate exceeds annual deaths from motor vehicle accidents.
Take the midpoint. Say 70,000 people per year. That is 192 people per day. Eight per hour. One roughly every 7.5 minutes.
You just read three sentences. In that time, statistically, someone in a U.S. hospital died from a mistake that did not have to happen.
We spend more money per person on healthcare than any other country on earth. More than Switzerland. More than Germany, Sweden, Norway, France, or Japan. The Peterson-KFF Health System Tracker confirmed it again in March 2026 [4]: the U.S. spent an estimated $14,885 per capita on healthcare in 2024. Switzerland, in second place, spent $9,963. The average for comparable wealthy OECD nations: $7,371.
We spend twice the average of our peers. We have the lowest life expectancy among those same peers, 79 years, 3.7 years below the comparable country average of 82.7 [5]. The Commonwealth Fund’s Mirror, Mirror 2024 cross-national comparison ranked the U.S. last among ten high-income countries on health outcomes specifically [6], a distinction that has not changed meaningfully in over a decade.
This is the deal we are getting.
The $30 Billion Bet That Mostly Moved Safety Scores
In 2009, as part of the American Recovery and Reinvestment Act, Congress passed the HITECH Act and set aside what the Congressional Budget Office estimated at $30 billion for Medicare and Medicaid Electronic Health Record incentive payments from 2011 through 2019 [7]. The objective had a name: Meaningful Use.
The logic was sound. U.S. hospitals were scandalously behind the rest of the developed world in digitizing patient records. At the time HITECH passed, 90 percent of hospitals did not have EHRs meeting federal requirements. The industry was roughly a decade behind comparable sectors in technology adoption.
The money worked, in the narrow sense. By 2015, nearly 78 percent of office-based physicians had certified EHRs. Hospital adoption accelerated dramatically. Epic, Cerner, and a handful of other vendors built what became the central nervous system of modern American hospital operations.
What the money did not do, and this is the argument nobody in the EHR industry wants to have, is move the outcomes needle in a meaningful way.
A 2016 analysis published in the journal Medicine, comparing outcomes at hospitals with high EHR adoption to those with low adoption, found that the association between EHR adoption and improved mortality, readmission, and complications did not hold up once other patient and hospital factors were accounted for [8]. The EHR improved documentation. It reduced specific, measurable categories of error. It connected clinical data that had been trapped in paper silos. It did everything it was architect to do.
It was architect to improve documentation. Not outcomes.
