In The End of Healing, Dr. Don Newman discovers that Dante’s representation of the moral organization of the universe (depicted above by the artist Botticelli) is a perfect ethical framework for understanding modern medicine. Don realizes that the levels of healthcare hell he has been exploring with Dr. Sampson in their seminar correspond perfectly with the levels in Dante’s Inferno. He discovers that for every ethical misstep, mistake, or error that Dante catalogued there is a corresponding mistake in modern healthcare.

From The End of Healing by Jim Bailey, Illustration by Joel Hilgenberg, copyright © 2014 by The Healthy City.

 So like Dante, he begins to catalog the errors in modern healthcare and to use Botticelli’s drawing as his guide. He realizes that these errors in health system organization have consequences in terms of money spent, lives saved, and lives lost and he begins to record these consequences in his own version of Botticelli’s diagram in his journal. He works night after night reviewing the literature, calculating and filling in the money spent, lives saved and lives lost in every sector of the healthcare industry. And here is what he discovers.

In his journey into the hell of the ordinary medical world Don discovers that the priorities of our healthcare system are completely upside down–and that this has horrible consequences for the people who depend on and need good health care for themselves and their families. Don discovers that where Americans spend the most—on hyped care, procedures, and hospital care—they get the least, the fewest lives are saved, and the most lives are lost from medical errors and complications. And where Americans spend the least is where the true high-value care lies, care that has the potential to not only save far more lives but also to help bring abundant life to the people of America. This is the reality of modern medicine in the United States, where it is currently estimated that $800 billion or one-third of the total $2.4 trillion U.S. healthcare budget is wasted on potentially harmful activities activities that do little or nothing to promote health.^[1],[2]

[1] Orzag PR, Statement to the Committee on the Budget, U.S. House of Representatives, Increasing the Value of Federal Spending on Health Care, July 16, 2008. Available at: https://www.cbo.gov/publication/41717; Accessed 9/10/15.

[2] Kelly R, Where can $700 billion in waste be cut annually from the U.S. healthcare system? Thomson Reuters, October 2009, Available at: http://www.ncrponline.org/PDFs/2009/Thomson_Reuters_White_Paper_on_Healthcare_Waste.pdf; Accessed 9/10/15.