The Real Drivers of Healthcare Waste
(And It’s Not Hospitals)
$760 billion to $935 billion. That is how much waste the U.S. healthcare system generates every year.
And most of it doesn’t come from the hospitals themselves. It comes from human beings making real-time decisions at the bedside: the doctors, nurses, and care teams trying to do the right thing every single day.
I had a chance to dig into this with Dr. Rich Klasco, Chief Medical Officer at Motive Medical Intelligence, for my series The Healthcare Leadership Operating System. What I learned reframed how I think about leadership in healthcare.
The Truth
Care decisions are made one patient, one provider, and one real-time choice at a time. This is where variation, outcomes, and costs are determined. It’s not always at the hospital or system level. Tracking hospitals alone is like trying to judge a symphony by counting the instruments instead of listening to the melodic tones.
This hit differently for me because I’ve lived through high-stakes decisions where clarity isn’t optional. It’s survival.
Dr. Klasco’s solution is Practicing Wisely, a clinician-level analytics system that doesn’t just throw dashboards at physicians. Instead, it gives actionable insights: where care teams follow evidence-based guidelines, where there is room for improvement, and how those choices ripple into outcomes and costs.
For healthcare leaders, this changes where performance actually lives. The next era of healthcare leadership isn’t about running programs or managing reports. It’s about designing the operating system that translates data into clarity, decisions into results, and disruption into opportunity.
Lessons That Stuck With Me
─ Broad metrics are blunt instruments. Precision insights are where leadership becomes real.
─ Transparency at the bedside matters. It builds trust and strengthens value-based care.
─ Data without alignment is useless. Frontline engagement ensures waste is reduced, outcomes improve, and patients receive better care.
Takeaway for Executives
Your impact isn’t in the dashboards or reports you review. It’s in the real-time decisions your teams make. Your job is to give them clarity.
Dr. Klasco reminded me: people on the front lines genuinely want to do the right thing. Give them the right insights, and results follow.
If you want a deeper dive into AI, clinician-level measurement, and advancing equity in healthcare, you can read the full interview with Dr. Klasco in Authority Magazine.
I am a journalist, keynote, and TEDx speaker, and the creator of Adaptive Resilience Leadership for healthcare executives. I help leaders navigate the period after major disruption, when the crisis has passed but the operating system no longer works. Organizations then enter what I call the Post-Crisis Leadership Gap. In this phase, decision quality and alignment quietly degrade, leading to costly delays and performance loss. I am a two-time cancer survivor and a board-certified health & wellness coach (NBC-HWC, ACC). I rebuilt after a life-saving stem cell transplant — a medical rebirth that revealed the gap between recovery and judgment under pressure. I have interviewed 2,000+ decision-makers across global stages and translate those insights into my best-selling book and high-impact keynotes: 🔗 saviopclemente.com ↗
Thank you for your post. While it is an excellent analysis, and America DOES spend more on "health care" than any other nation, many things were skipped in your post. Fort starters, Americans would be healthier if not for non-stop and banal drug commercials that permiate our airwaves each day. Other things almost ALWAYS forgotten in "health care" are what is right in front of all of us: Neglect of "basic" nutrition tools and polypharmacy. Keeping this post as short as possible, here goes: NOT keeping vitamin D above 75ng/ml (& < 100), (most Americans, esp. those with AI disorders and cancer are below 30 ng/ml), NOT avoiding GMO foods, NOT avoiding foods containing "bio-engineered food ingredients," NOT avoiding H.F.C.S., NOT minimizing intake of processed foods, NOT exercising at least 3-7 hours/week, (unless disabled in some way), NOT avoiding/minimizing exposure/consumption of microwaved foods, NOT minimizing EMF exposures, and esp. 5G exposures, NOT eating mostly organically grown foods and NOT using natural, non-toxic "meds" whenever possible instead of often toxic Rx meds. Perspicacity matters, and THIS is how to stay out of hospitals. There's a reason I still run 25-30mpw, (at 67.8 years of age), and it is because I follow such "basic" rules to avoid hospitals at all possible times. Too bad many Americans forget that good health (and avoidance of illness), depends on following 'basic' rules. And the most important is to avoid ALL vaccines, esp. the (so-called) Covid vaxxes, which are not vaccines in any way. So this writer has not had any shots since 1976, the MOST important tool to having a strong immune system. Disagree? No problem, how is YOUR health now? And ask yourself, after a survey of 1 million kids with myocarditis, ALL were Covid-vaxxed. Incidence in non-vaxxed kids? Exactly zero cases. Sorry, now this post is too long. long.file:///C:/Users/uniqu/OneDrive/Books/Covid__Book__2025.pdffile:///C:/Users/uniqu/OneDrive/Books/Covid__Book__2025.pdf