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"A different kind of public option?" Health care by the people, not for profit

In this episode of the “America Dissected” podcast, I discuss with host Dr. Abdul El-Sayed a fundamental question about the US health care system.

 “So the US health care sector currently consumes something like 20% of GDP,” I say in the podcast. “And my question is, if you asked almost any doctor, nurse, public health expert, patient, or public policy specialist to take 20% of US GDP and design a system to maximize the health and well-being of Americans, would anyone design anything that remotely resembles the health care sector that we have now? And my bet is that they wouldn’t, right? So that’s my starting place.”

In this podcast, we explore what health care as a public service, as opposed to health care as a profit-making enterprise, would look like. 

“Health and health care can really be conceived of as public goods. And from that standpoint, thinking of them as something that should be made available to all because they have positive externalities for society, well, that in of itself makes an argument for a big role for the public sector in assuring that those public goods exist and are indeed available to them all.”

The inequities and dysfunction in the US health care system—which spans from exorbitant prescription drug prices to closures of inner-city and rural hospitals—are a byproduct of a health care system design that is centered on maximizing profits for investors and shareholders rather than equitably and affordably providing the best healthcare possible. In order to get a different outcome, we need a different design. Public ownership could be a vehicle for the designs that we need to produce superior outcomes for population health, but also for our economy and democracy.

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