Health Costs Keep Rising, But the Evidence Points Away from Physicians
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- Key Point: U.S. health spending reached $5.26 trillion in 2024, or $15,474 per person, yet the authors argue the cost problem is not primarily driven by physicians.
- Why it Matters: The physician workforce grew about 29% from 2004 to 2024, while real health spending grew about 71%.
- Impact on Practice: Prior authorization, documentation mandates, and utilization management often shift costs into administrative work for practices.
- Policy Direction: The authors call for administrative simplification, price discipline, antitrust enforcement, and recalibrated oversight of clinical care.
A new American Journal of Medicine article, “Connecting the Dots: Why United States Health Care Costs Keep Rising — It’s Not the Doctors,” argues that the nation’s cost problem has been misdiagnosed. The article is authored by MSSNY President Mark J. Adams, MD, MBA, FACR; MSSNY Commissioner of Communications Hemant Kalia, MD, MPH; and MSSNY member Sahar Elezabi, MD.
The authors note that U.S. healthcare spending reached $5.26 trillion in 2024, equal to $15,474 per person and 18.0% of gross domestic product. They argue that much of the cost-control policy built since the mid-2000s has rested on the theory that costs rise because clinicians order too much care or are paid too generously.
But the data points in another direction. After adjusting for general inflation, real health spending still increased by approximately 71% from 2004 to 2024, while the active physician workforce grew by roughly 29%, close to population growth and far below the rise in spending.
The article identifies prices and administration, not physician volume, as the central drivers. The authors cite evidence that the United States does not use more care than other high-income countries but pays more per unit of care and spends far more on administering the system.
For physicians, this matters because many “cost-control” tools—prior authorization, documentation mandates, narrow networks, and utilization review—create administrative work without necessarily addressing the structural causes of high costs.
MSSNY continues to advocate for New York physicians by challenging policies that blame doctors for systemic cost growth and impose new burdens on patient care. Learn more and stay engaged at mssny.org.
Connecting the Dots: Why United States Health Care Costs Keep Rising — It’s Not the Doctors (Kalia, MD, MPH, Elezabi, MD, and Adams, MD, MBA, FACR, AMJMED, 8/25).
