This report, prepared by the Chief Operating Officer of Tenet Healthcare Corporation, examines the significant growth in healthcare spending over the past 50 years. It identifies key drivers such as increased demand for services, technological advancements, rising prescription drug costs, and medical malpractice liabilities. The report highlights the impact of an aging population, the influence of new medical technologies, and the increasing cost of prescription drugs on healthcare spending. It also discusses the effects of medical malpractice liability and government regulations. Furthermore, the report explores the implementation of health care payment and delivery models, the role of electronic health record systems, and the implications of performance incentives. The analysis concludes with recommendations for cost containment and quality improvement, emphasizing the adoption of electronic health record-keeping and other analytical frameworks to achieve accountable care within the healthcare system. The report includes references to relevant research and studies.