Four years ago, a 55-year-old catholic priest named Father John Corapi set off an FBI investigation that brought down Redding Medical Center’s chief cardiologist and cost Tenet Healthcare, the hospital’s corporate parent, hundreds of millions of dollars in legal settlements. The cardiologist, Dr. Chae Hyun Moon, had told Father Corapi that he needed an emergency triple-bypass operation. But as Corapi was being wheeled into the operating room, another surgeon examined Corapi’s x-rays and could find nothing wrong. His heart was healthy.

Stunned, Corapi called law enforcement officials, who launched an investigation. Government lawyers ultimately accused Moon of operating on scores of healthy hearts, and of fraudulently billing Medicare for the surgeries. At the time, Moon’s cardiology unit was one of Tenet’s biggest profit centers.

The Redding case drew local and national media attention, including a segment on 60 Minutes. But a more significant if quieter case had unfolded a year earlier when San Jose cardiologist Eleanor Levin astonished a convention of American Heart Association doctors with results from a comprehensive heart care program she’d spearheaded at Northern California Kaiser. Levin’s study showed that plan members were 30 percent less likely to have a heart attack than other Californians. Remarkably, Levin’s program involved no dazzling new drugs or therapies. Instead, Kaiser employed computer records to identify people at risk and ensure they received treatments known to be effective—mostly ordinary drugs such as aspirin, beta-blockers, and statins.

The two cases represent opposite poles in American health care, and one obvious moral would be for all doctors to be more like Levin and all health care plans more like Kaiser. But health care, as Hillary Clinton learned at great cost, turns out to be too complex and varied—rural and urban, rich and poor, primary and specialist care, emergencies and chronic illnesses—for single-shot solutions.

For years, Americans believed their health care system to be the best in the world. We rightfully claim leadership in new research-based diagnostic tools and new therapies that have increased our life spans and quality of life. Future U.S.-led innovations in stem cell research and bio-engineered drugs hold transformative promise. True, costs have soared, but so has our success in treating diseases that were once crippling or fatal.

In delivering health care, though, dozens of studies paint a different picture. One RAND study concluded that nearly a third of American health care is the wrong care. Only half the hospitals in the U.S., for example, reliably provide five simple follow-ups proven to reduce deaths among heart surgery patients; one is prescribing aspirin. Procedures are performed that shouldn’t be, as Dr. Moon was accused of repeatedly doing. Misadministered drugs and other errors account for up to 98,000 hospital patients dying unnecessarily every year. The extent of wrong care goes a long way toward explaining why America spends far more per capita on health care than any other advanced country—more than twice as much as Sweden, Italy, Japan, or Britain—yet ranks dead last on critical measures such as life expectancy, infant mortality, and equity.

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