“It’s the prices, stupid,” Uwe E. Reinhardt and authors famously wrote in their 2003 article describing the cause of high health care spending in the United States.1 Since then, multiple large analyses have confirmed that the prices of labor and goods, including pharmaceuticals and administrative costs, more so than differences in utilization, are the primary drivers of high health care spending.2,3
How’s this for a paradox: The better cancer centers become at keeping patients alive, the more expensive cancer care becomes. This brutal tradeoff hits harder in rural areas, where the cancer burden is higher and the investigator and clinical trial representation is lower.
