There are few things as private as the medicines we take. You can imagine asking a decent acquaintance who they voted for in 2008, who they’ve dated in the past year, and which family member they hate the most. But I’ll bet it makes you feel queasy to imagine asking them, “Hey! That little blue pill I saw in your bag. What’s that for, anyway?”

It’s no wonder then that America’s problem with overmedication hides in plain sight. While we’re all dimly aware that we take a lot of pills, we have no intuition of how big the problem is. And when you lay out the stats, the figures are nothing short of terrifying, as this infographic shows. While it suffers from rhetorical bombast, the tensions suggested by the chart are stark: Even though we take tons of pills, they seldom actually work. So while 1/2 of all Americans take a prescription drug and 1/4 of women take an anti-depressant, prescription drugs only seem to work 30% of the time. Meanwhile, 85% of new drugs have been found to have little or no benefit. And those miracle anti-depressants? They don’t even outperform placebos:

As you might have guessed, the authors of this infographic lay the blame squarely on the shoulders of the drug companies, which spend far more money pushing their drugs with doctors than they do on research, and the FDA, which allows them to market the drugs they sell despite their limited effectiveness.

Doctors, in the meantime, straight up get paid to prescribe new drugs. If you’ve ever wondered why so many young, energetic women are making $250,000 a year to be pharmaceutical representatives, there’s your answer.

No doubt, doctors and pharmaceutical companies make for troubling dance partners. Without their cozy ties, perhaps the problem of overprescription wouldn’t be so bad.

But the infographic also misses the most important part of the story. While drug companies indeed have a vested interest in marketing their drugs to whomever will buy them, even if they don’t work, they’re abetted by our profoundly screwed up insurance system. In short, it creates some of the worst, most irrational incentives imaginable.

There is also a deeper problem driving all of this behavior: Magical thinking.

Think about the process behind a drug prescription from the viewpoint of each person involved. For many doctors, the cost of a drug is totally invisible: They don’t prescribe them with any concern for cost-effectiveness or even clinical efficacy–indeed, when I’ve asked a doctor how much something costs, I’ve often gotten a snippy reply, as if asking about money were some kind of moral insult. Instead, there’s merely the doctor’s own vague sense of what usually works. If they’re told about something that’s new and supposedly better, why wouldn’t they prescribe it? If it costs 10x more than a previous generation of drug, who cares? Likewise, patients with insurance don’t pay the costs of medications, so they’re only too happy to take one more drug, under the assumption that it can’t hurt.