Why is American health care so expensive?

This morning I received an invitation to sign a letter authored by the Lown Institute  in support of an article published in the BMJ (formerly the British Medical Journal) questioning the wisdom of prescribing statin drugs to patients at low risk of cardiovascular disease such as heart attack or stroke. "Statins" such as lipitor (atorvastatin) and zocor (simvastatin) are drugs which reduce cholesterol levels by inhibiting an enzyme on cell membranes. The article  concludes that statin drugs are unlikely to be helpful to patients whose risk of heart disease or stroke is calculated to be less than 20% in 10 years. It was written by Dr. John Abramson, a lecturer at Harvard Medical School and the author of two books about inappropriate use of medications and tests, Harriet Rosenberg, a social scientist from Canada who has written about the lack of good scientific study of statins in women, Nicholas Jewell, a statistician from UC Berkeley and Dr. James M. Wright, a professor at...

In 1971, as medical science was wrestling with the observation that elevation of cholesterol levels was associated with heart attacks, a Japanese chemist named Akira Endo discovered a substance that inhibited the enzyme HMG CoA reductase and thus lowered cholesterol levels. His original chemical was never introduced due to significant muscle toxicity and the fact that it caused tumors, but not long after, a less toxic version was introduced under the brand name Mevacor (Lovastatin.) This drug was significantly more powerful in lowering cholesterol levels than the unpleasant and relatively ineffective drugs that came before. These are still used today, but are difficult to take, including ones that taste like sand and absorb cholesterol from the gut as well as high dose niacin which causes itching, flushing, worsens diabetes and exacerbates gout.  Lovastatin could be dosed once daily, was an innocuous capsule, and lowered cholesterol strikingly. Since that time, many more HMG CoA ...