Healthcare expenditures vary a lot between countries, and even between regions within countries. The US for example spends per capita almost three times as much as Finland. Yet health outcomes between most industrialized countries are roughly the same. In his search for an explanation, Doctor Gawande from the New Yorker travels to McAllen, Texas, one of the most expensive healthcare markets on earth. Written like a real whodunit, the article discusses different plausible explanations for these differences in expenditures and ends with some important recommendations in order to keep them under control. A must-read for all healthcare professionals!