Ashish Jha is a health care professor at Harvard. And there’s this thing he used to say when he gave talks, a thing he thought was definitely true about the American health care system.

”I have probably said in more than a dozen talks that our health care system is much more specialty care-driven, whereas in Western Europe there are more primary care physicians, and that mix is just really different,” he’s said. “That mix is really different, and that drives the use of high-cost services. I’ve repeated those words.”

Jha isn’t quite sure where he learned this — it was just a truism of American health care that he took for granted (and, to be fair, a truism that I’ve also taken for granted as a health care reporter).

But Jha doesn’t believe this anymore. Earlier this month, he and two co-authors published a paper in the Journal of the American Medical Association that is one of the most comprehensive studies of what actually drives high health care spending in the United States.

He looked at […]