( CNN ) -- Helen , 50 , was college educated , married , worked in middle management at a financial services company and had good health insurance . She was diagnosed with early stage breast cancer in 1990 . She saw doctors with some of the best reputations . After an appropriate surgery , she was given high dose chemotherapy with a bone marrow transplant . The treatment almost killed her several times and she was hospitalized for nearly a year . My book , `` How We Do Harm , '' co-authored with Paul Goldberg describes the challenges that some ordinary Americans experience while trying to get quality health care . In the book we show real examples , like Helen , of the irrationality of how medicine is practiced and consumed in the United States . We discuss those who do not get good care and those who suffer because of excessive and illogical health care . Both occur among the insured and the uninsured . The book also assesses the threat our health care system poses to the economy and offers suggestions on what needs to change . It was motivated by the ongoing debate about health care reform . For more than two decades , I have studied disparities in health outcomes and the inconsistencies in how medicine is practiced . I have come to believe that much of the rhetoric for and against health care reform lacks the understanding that the issue involves human beings . Lost in that debate is the fact that a large number of our fellow Americans are suffering and dying avoidable deaths , because of lack of quality health care . I believe we should be both ashamed and furious about our health care system . America spends more per person on health care than any other country . Per-person costs are nearly 1.5 times higher than the second most expensive country . We simply do not get the outcomes we pay for . Among the nations of the world , we rank 50th in life expectancy and American life expectancy is decreasing . America is 47th in infant mortality , just better than Croatia . The therapy Helen received was expensive and commonly given to women with breast cancer in the early 1990s . During this time , numerous women sued insurance companies who did not want to pay for the therapy and nearly a dozen states passed laws saying insurance companies had to pay for it . There was one really good reason why the health insurers did not want to pay for high dose chemotherapy and bone marrow transplant for breast cancer : No study had ever been done to prove it beneficial . Even without evidence , some patients and their doctors had faith that it worked . The procedure was common because some doctors taught that the transplant was beneficial to patients . Truth be told , it was very beneficial to the doctors and hospitals offering it . By 1999 , well after Helen had recovered , three well-designed clinical trials were completed . They showed that bone marrow transplant and high dose chemotherapy , a treatment now common for nearly a decade and a half , was not better than the standard therapy and there were indications it was more harmful . This shows that even the well-insured often get substandard care . Medical gluttony , the inappropriate use and overuse of medical treatment , is not just adding unnecessary cost to health care . It can actually be harmful to the individual . Doctors deserve some blame for this mess . Appreciation of the science of medicine and the scientific method is often lacking . It is amazing the number of health care professionals who seemingly reject the scientific method . They prescribe treatments they believe to be appropriate as opposed to therapies that are known to be appropriate based on objective scientific evidence . This form of ignorance is a root cause of much of the overuse of medical therapy . Too often , doctors fail to distinguish what is scientifically known from what is unknown , from what is believed . This is beyond mere disagreement about interpretation of the science . There is often selective reading of the science , especially by those trained in a specialty wanting to advocate for it . Health care providers and the public often overlook the emotional and financial conflicts of interest of health care professionals . While I blame the medical profession , blame also rests on hospitals , drug and device manufacturers , insurance companies , lawyers , politicians , government and even with patients . I see hospitals advocating unproven screening and treatment while advertising for business . There are patient advocacy groups often funded by hospitals and medical manufacturers , who also advocate the unproven and instill in patients that they need what may be unnecessary and can be harmful . American medicine is big business . It is about 18 % of the U.S. economy and growing . The average cost of a health insurance policy for a family of four is $ 19,400 per year . The expense of our inefficient health care system is a major drain on the economy . It is a major reason why employers are hesitant to hire and a reason why many employers can not provide health insurance to employees . We have what could be an extraordinary health care system and some patients do get extraordinary care . But patient stories show how our system is inefficient . Our system is focused on treating people after they get sick with relative inattention to promoting health and preventing disease . Such public health efforts have not received adequate support . The triad of obesity , lack of physical activity and high caloric intake ( bad diet ) is creating a tsunami of chronic disease . If the system persists as is , medical costs will grow dramatically over the next several decades as the number of patients with diabetes , cardiovascular diseases , cancer and orthopedic injury dramatically grows . The current course is not sustainable . Medical costs will rise until the economy collapses . I know that the book will upset and anger some people , especially those who profit from medicine . I hope the book allows some reasonable people ( both lay and medical professionals ) to better understand what we are doing to our country . We all need to realize that some Americans are harmed by lack of treatment and others by overtreatment . The cold hard reality is America does not need to reform health care , we need to transform health care . The American health care system is fundamentally flawed and encourages inappropriate behavior and a subtle form of corruption . There truly is a combination of greed , ignorance and apathy within health care that is a cancer on this country . There is nothing wrong with medicine as a business , and nothing wrong with making an honest profit . However , in some cases , greed needs to be replaced with public interest , a concern for the national good . We need a greater commitment to the practice of evidence-based medicine . Some politicians choose to scare people with words like `` rationing medicine '' and `` death panels . '' Truth be told , we all need to talk about defining the `` rational use of medicine . '' A widespread demand for rational use of health care can lower costs and increase the number of people getting high quality care and save lives . Americans need to better understand the science of medicine and the scientific method , be true to science and support evidence-based medicine . We need to embrace an interest in public health and adopt preventive strategies . The most important question we can ask is , `` How can we provide all Americans with good high quality care to include preventive care ? '' Opinions expressed are those of the author and do not necessarily represent those of CNN , The American Cancer Society , or Emory University .
America ranks 50th in life span and American life expectancy is decreasing . We should be both ashamed and furious about our health care system , he says . We focus on helping people after they get sick instead of preventing disease , he says .