Here's a better example than a "car crash", because this diagnosis and treatment happens much more frequently:
Increasing incidence of overweight and obesity in adults has caused another medical issue to blossom (along with heart disease, diabetes, etc.): sleep apnea. Over the last 10 - 15 years a whole new discipline that has sprouted up in medical centers and hospitals to "treat" it. Many local medical centers in our area have "sleep centers" for folks to be evaluated. These lead to the sale of c-pap devices which are the leading treatment methodology for sleep apnea.
Except that the whole practice is cock-eyed. According to
Harvard Medical School, the best treatment for sleep apnea is weight loss. But since weight loss is "so hard", the c-pap device is prescribed.
C-pap is not a cure, and its so bloody uncomfortable to wear during the night that most patients
abandon treatment over time. But treatment is abandoned long after the doctor has been paid, the hospital where the sleep center evaluation was completed got paid and the c-pap device was paid for by the health insurance carrier, Medicare, whatever. Sometimes the patient experiments with multiple masks to try to get one that feels / fits the best, and all of those got paid for too, BEFORE the patient abandons treatment.
Everyone gets paid, the patient still has sleep apnea, is still overweight, and the medical industry continues to send new patients to sleep centers and prescribe c-pap devices because THAT'S WHAT THEY GET PAID TO DO.
If the docs/hospitals/medical device manufactures were reimbursed based on successful outcomes, I suspect we'd have fewer overweight / obese patients (because weight loss leads to other many healthy outcomes) to begin with, we'd have far fewer "sleep centers", and the c-pap would be prescribed only in very limited cases. And, more important, the costs incurred to get to that healthy outcome would be far less.