After looking at health care data for a long time, my point of view on our system is expressed in this essay.

I define activist medicine as procedures, treatments, and consultations that have a low probability of affecting the outcome. The procedures and consultations are undertaken to rule out unlikely possibilities, to confirm diagnoses, to improve chances of success, and to reassure patients.

I mean for the term “activist medicine” to be neutral, rather than positive or pejorative. I believe that there are people walking around healthy today only because an activist practitioner found something on an MRI or in a consultation in time for treatment. Just because the probability is low does not mean that the outcome is unimportant to the individual.

If my diagnosis of what explains the increase in U.S. health care spending over the past 25 years is correct, then single-payer health care is not the right prescription. Instead, we need better studies of cost-effectiveness of health care practices, better education of patients and doctors, and less insulation of patients from the cost of procedures.

For Discussion. What anecdotal and statistical evidence is not consistent with this diagnosis?