Talk to experts and many agree that waste would be a good place to start. In 2012 the National Academy of Medicine estimated that the U.S. health care system squandered $765 billion a year, more than the entire budget of the Defense Department. Dr. Mark Smith, who chaired the committee that authored the report, said the waste is “crowding out” spending on critical infrastructure needs, like better roads and public transportation. The annual waste, the report estimated, could have paid for the insurance coverage of 150 million American workers — both the employer and employee contributions.

“It’s unconscionable that we’re not only wasting money in health care, but in doing so are sacrificing other important social needs,” Smith said.


Smith’s committee blames the obvious villains — overtreatment, excess administrative costs and high prices — for most of the fat in the system. Left untallied, however, are the discards that arrive in waves into McLellan’s warehouses, most of which would otherwise end up in landfills. McLellan estimates the goods her group has right now are worth $20 million. Sure, that’s a rounding error in the overall waste tab, but it starts being real money if you add up the discards of all the nation’s medical facilities.

Researchers at the University of California, San Francisco Medical Center, for instance, recently estimated that in a single year the hospital wasted $2.9 million in neurosurgery supplies alone. Nearly $3 million. On wasted supplies. In one department.

Last year Partners sent seven containers overseas, each weighing up to 15,000 pounds and with an estimated value of up to $250,000. One is being sent to Syria this week. It includes an ultrasound machine ($25,000), a dozen trocars ($4,400) and an infant warmer ($3,995).

MedShare, a Georgia-based nonprofit more than 10 times the size of Partners, sent 156 containers of discarded medical supplies to developing countries last year, each one worth as much as $175,000. As lawmakers debate, ProPublica is setting off to document the rarely examined — and mind-boggling — ways your health care dollars are frittered away. Our first stop: the world of “medical surplus.”

THERE’S A DISPLAY CASE in the Partners headquarters that sums up the heedless wealth of American health care. On one side are medical supplies McLellan brought home from Bangladesh: a yellowed plastic respirator mask, dirty tubing and a bloodstained square of gauze that’s brown and stiff from being washed and reused over and over again. Above them a sign reads, “Shared By Thousands.” On the other side are the same items, sterile and new, the discards of local health care facilities in the U.S.

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