When Mary sat down with Zeke Emanuel, one of the main architects of the Affordable Care Act, she basically wanted to know one thing: if the ACA was supposed to revolutionize healthcare, how come she still can’t understand her medical bills?

Even though he’s an oncologist, bioethicist, and healthcare wonk, Dr. Emanuel still struggles to navigate the system. Arcane hospital bills stump him, too. So if patients aren’t to blame for not understanding medical costs, is there anything we can do? Emanuel suggests that we start looking closely at the number of medical tests we sign up for.

Take the PSA blood test for prostate cancer: it prevents a very small number of deaths, and often results in overdiagnosis. Some doctors disagree with him, but Emanuel sees it as a totally unnecessary expense that can lead to even more costs. He has never wanted one for himself, yet he’s been given the test twice — without being aware of it. When a doctor called to give him his results, Dr. Emanuel slammed the phone down before hearing them. He believes the PSA leads to unnecessary worry — and, more importantly, unnecessary treatment for men in this country.

This week, Dr. Emanuel talks about what you can do to be a smarter consumer of healthcare, and the ways the system might be slowly changing to help all of us — doctors, hospitals, insurers, and patients — understand cost better.