IntroductionThe United States uses nearly $9,000 per capita for healthcare expenses, significantly higher than all other countries. Why do we spend so much more when our quality doesn't even compete? Numerous medical tests and procedures performed on patients are completely unnecessary. For example, some women have a specific date they would like to give birth, so they will request an optional early birth. An early elective birth is labor induced between the 37th and 39th week of pregnancy and that too without any legitimate medical necessity. These types of births cause many newborns to be admitted to the neonatal intensive care unit (NICU). These incidents could be completely avoided if doctors prevented women from requesting premature labor. Literature Review In the 1970s, John Wennberg noticed that there was great variation in the cost of medical procedures in different regions of the United States. In 2008, end-of-life care per Medicare beneficiary in the state of New Jersey was $59,379 and $32,523 per beneficiary in North Dakota (Wennberg, 2008). Unfortunately, no relationship was evident between increased spending and quality of care. So, to explain this phenomenon, it is necessary to further explore medical procedures that may not be necessary. In the United States, several groups of people are affected by this problem, but the main group is the elderly, mainly due to their increased need for medical care and inevitable end-of-life care. Since expenses vary from state to state, a good way to improve the overall average is to find the best cost and quality based on mortality across all hospitals. Consequently, if all hospitals imitated the strategies of the hospital with the highest… paper center… if the healthcare system as a whole transformed into a patient- and doctor-friendly system. Works Cited Baicker, and Chandra. (2004). Medicare spending, physician workforce, and quality of beneficiary care. Health Affairs (Millwood), 184-197.Fisher, Wennberg, Stukel, Gottlieb, Lucas, and Pinder. (2003). The implications of regional variations in Medicare spending. Part 1: Content, quality and accessibility of care. Annals of Internal Medicine., 273-287.O'Connor, Llewellyn-Thomas and Flood. (2004). Changing unwarranted variations in health care: Shared decision making using patient decision aids. Health Affairs (Millwood), 63-72.Wennberg. (September 17, 2007). The deep dive. DMAA Annual Meeting;, 50-62.Yasaitis, Fisher, Skinner, and Chandra. (2009). Hospital quality and spending intensity: is there an association? Health Affairs (Millwood), 566-572.