[Chicago Business, September 28, 2009] During a medical consultation with an 81-year-old lung cancer patient last spring, Deon Cox-Hayley came face-to-face with Chicago's medical-spending problem. The man had been to more than 50 appointments at the University of Chicago Medical Center for chemotherapy, radiology scans and blood-thinner injections since his December diagnosis—treatment that continued even after his oncologist deemed his condition terminal. In this article that examines why Chicago's health care costs are high relative to other Midwest cities, Penny Wheeler, M.D., chief clinical officer of Allina Hospitals & Clinics, was interviewed about how Minnesota's integrated systems compete for clinical quality.