Overtesting, overdiagnosis, and overtreatment in medical care in the U.S. is widespread, with one recent study suggesting that 30% of care—amounting to roughly $750 billion a year—is wasteful. But there are signs that the Affordable Care Act, which provides financial incentives for doctors to provide better quality care at lower cost, is prompting increasing numbers of health care providers to recommend only truly necessary care to their patients.

“Millions of people are receiving drugs that aren’t helping them, operations that aren’t going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm,” wrote Atul Gawande, professor in the Department of Health Policy and Management at Harvard T.H. Chan School of Public Health and executive director of Ariadne Labs, in the May 11, 2015 issue of the New Yorker, where he is a staff writer. But Gawande also wrote about promising trends that are lowering health care costs and boosting health outcomes—including in McAllen, Texas, a town that Gawande wrote about six years ago in the New Yorker because of its extremely high health care costs, but which has since then brought those costs down significantly.

“We’re finally seeing evidence that the system can change—even in the most expensive places for health care in the country,” Gawande wrote.

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