A Different Way to Rein in Health Care Costs
Psychology Today
by Robert C. Smith MD, MACPFebruary 20, 2026
AI-Generated Deep Dive Summary
The article presents a bold and unconventional perspective on addressing the rising costs of American healthcare. Rather than focusing on the usual suspects—such as insurance reform or pharmaceutical pricing—the author argues that the root cause lies in medical education. The way physicians are trained shapes their approach to patient care, influencing everything from prevention to treatment. By prioritizing physical disorders over psychosocial factors, medical schools contribute to a system that often overlooks mental health, lifestyle choices, and social determinants of health.
The article highlights how this narrow focus on biomedical science creates significant challenges. For instance, primary care clinicians are rarely equipped to diagnose or manage mental health conditions, even though mental illnesses frequently present in these settings. This gap not only affects patient outcomes but also drives up healthcare costs. Preventable chronic diseases like heart disease and diabetes account for a staggering 80% of cases, yet the underlying psychosocial factors—such as stress, substance use, and poor lifestyle habits—are often ignored. This leads to a cycle of repeated treatments, higher pharmaceutical use, and escalating expenses.
The financial implications are clear: a healthcare system that emphasizes intervention over prevention inevitably becomes more expensive. By neglecting the emotional and behavioral drivers of illness, the system ends up treating symptoms repeatedly instead of addressing root causes. This approach not only strains patients but also fuels the growth of industries like pharmaceuticals and medical devices, which thrive on complex treatments rather than preventive care.
The article underscores why this matters to anyone concerned about healthcare costs and quality. By rethinking how physicians are trained, we could shift the system toward a more holistic approach—one that prioritizes prevention, mental health, and social factors. This would not only improve patient outcomes but also reduce long-term expenses, making healthcare more affordable and sustainable for everyone.
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Originally published on Psychology Today on 2/20/2026