Why is American health care so expensive?

I am in the African Republic of Tanzania. This year I have again accompanied a group of medical students from University of California at Irvine who will be teaching bedside ultrasound to clinical officer students at a medical school in Mwanza, the second largest city in this East African country. We will also be looking at the utility of ultrasound in diagnosing schistosomiasis, a parasitic disease which is endemic here. Mwanza is on the coast of Lake Victoria, a huge body of water also bordered by Kenya and Uganda. Much of the commerce here has to do with the lake, both relating to tourism and fishing. Schistosomiasis is a water borne disease caused by a fluke that lives in the lake, harbored by snails. The snails are infected by the schistosomiasis miracidia and shed cercaria capable of infecting humans into the beautiful blue water where they penetrate the skin of mammals that swim in the lake. The flukes move through the lymphatic system, penetrate the blood vessels of the lun

"They should make an ultrasound probe that plugs into your laptop. It could just hook into a USB port." Ultrasound technology has become progressively more accessible to doctors who aren't radiologists. During my training, some obstetricians imaged the bellies of their pregnant patients to quickly see how the baby was lying in the womb and assess its progress. Other than that, ultrasound resided in the realm of the radiologists, who lived in dark rooms and interpreted blurry pictures for the rest of us. Since ultrasound is not expensive and has many potential applications, far beyond just seeing fetuses, other specialties have adopted it and doctors in resource poor countries where there are no radiologists have come to rely on it for all sorts of information. Trauma surgeons and emergency physicians can use it to rule in or out life threatening conditions, and internal medicine physicians like me can improve on the accuracy of our physical exams and sometimes avoid t