While U.S. has the world’s most technologically advanced health care system, it also has the highest costs of comparable countries—and poorer outcomes. Health policy expert John McDonough wonders if the outsized role of for-profit companies in the U.S. health sector may explain the differences.
In an opinion piece in the November 2019 Milbank Quarterly, McDonough, professor of the practice of public health at Harvard T.H. Chan School of Public Health, pointed out that U.S. spending on health increased from about 8% of gross domestic product (GDP) in the late 1970s to 17.8% in 2017, far ahead of the nation with the next-highest health spending, Switzerland (12.2%).
In spite of this massive investment, life expectancy has been declining in the U.S. for the past three years. There are also “humiliating rates of infant and maternal mortality, shocking levels of gun violence, and extreme incidence of overweight and obesity,” McDonough wrote.
Noting that the for-profit health sector continues to grow, McDonough suggested that it’s time to fully examine “the history, experience, and results from for-profit corporatization of our health and medical care sector.”
He added, “It is clear that this revolution produces good and bad results for American society and for the world. Is it time for a reckoning?”
Read the Milbank Quarterly opinion piece: Shareholders, Stakeholders, and US Health Care