H. Gilbert Welch has told us this before, but he doesn’t think we’ve been listening: The central problem with U.S. medical care is not that it’s expensive or complicated or impersonal – it’s that there’s too much of it, and too much of it is ineffective.

The author of Overdiagnosed and Should I Be Tested for Cancer? has now written Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care. Welch, a physician and professor at Dartmouth Medical School with a talent for lively writing, says he can imagine his eye-rolling daughter saying, “Dad ... you keep saying the same things over and over.” This time ,he constructs his arguments against overmedicalization in terms of seven pithy “assumptions” contrasted with seven “disturbing truths.”

“Assumption No. 1: All risks can be lowered. Disturbing truth: Risks can’t always be lowered – and trying creates risks of its own.” This chapter on what we do and don’t know about risk assessment includes a hilarious sequence beginning with a news story headlined “Cancer risk increases with height.”

Then there’s “Assumption No. 3: Sooner is always better. Disturbing truth: Early diagnosis can needlessly turn people into patients.”

Thus he begins his protest against too much screening, which he cogently argues cannot be shown to save lives and frequently cause excessive fear, false diagnosis and needless treatment.