US commercial insurers pay 254% of Medicare for the same hospital procedures

The US spends ~$14,570 per person on healthcare.

Japan spends ~$5,790 and has the highest life expectancy in the OECD.

That gap is roughly $3 trillion per year.

This project finds it, one issue at a time.

Each issue identifies one fixable problem, quantifies the waste from primary federal data, and recommends a specific policy fix.

All code is open-source.

Anyone can reproduce the analysis.

Issue #1 — Medicare's OTC Drug Problem (~$0.6B/year)
Medicare Part D pays prescription prices for drugs available cheaply over-the-counter.

Step therapy reform — requiring OTC equivalents before prescription coverage activates — would redirect roughly $0.6 billion per year in unnecessary spending.

Issue #2 — The Same Pill, A Different Price (~$25.0B/year)
Issue #3 — The 254% Problem (~$73.0B/year)
Through 3 issues: ~$98.6 billion in identified savings
Every analysis uses primary sources: CMS cost reports, Part D claims data, OECD health statistics, RAND pricing studies.

Every number has a citation.

Every script is reproducible from a clean clone.

Caveats are named explicitly.

The math is the argument.

Built by Andrew Rexroad .

Questions, corrections, or data tips: vonrexroad@gmail.com