In “Is the US Health Care System Wasteful and Inefficient? A Review of the Evidence,” Sherry Glied and Adam Sacarny examine the common wisdom that the American health system is inefficient. Throughout the authors are precise in their definition of inefficiency. Specifically, following the framework of economics, inefficiency relates to excess provision of care relative to what would be needed to generate the same amount of health. High prices, while a prime determinant of high spending in the United States, are not necessarily evidence of inefficiency. Similar, greater care provided because of poor American health behaviors, and thus greater need, would also contribute to higher spending in the United States but would not indicate greater inefficiency.

There are a few definitional issues worth noting. Inefficiency may reflect using too many resources (or an unnecessarily expensive mix of inputs) to produce specific services,...

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