An Introduction to the US Health Care Industry: Balancing Care, Cost, and Access

Why does US health care have such high costs and poor outcomes? Dr. David S. Guzick offers this critique of the American health care industry and argues that it could work more effectively by rebalancing care, cost, and access.

For decades, the United States has been faced with a puzzling problem: Despite spending much more money per capita on health care than any other developed nation, its population suffers from notoriously poorer health. In comparison with 10 other high-income nations, in fact, the US has the lowest life expectancy at birth, the highest rates of infant and neonatal mortality, and the most inequitable access to physicians when adjusted for need.

In An Introduction to the US Health Care Industry, Dr. David S. Guzick takes an in-depth look at this troubling issue. Bringing to bear his unique background as a physician, economist, former University of Rochester medical school dean, and former president of the University of Florida Health System, Dr. Guzick shows that what we commonly refer to as the US health care "system" is actually an industry forged by a unique collection of self-interested and disjointed stakeholders. He argues that the assumptions underlying well-functioning markets do not align with health care. The resulting market imperfections, combined with entrenched industry stakeholders, have led to a significant imbalance of care, cost, and access.

Using a nontechnical framework, Dr. Guzick introduces readers to the economic principles behind the function―and dysfunction―of our health care industry. He shows how the market-based approach could be expected to remedy these problems while detailing the realities of imperfections, regulations, and wealth inequality on those functions. He also analyzes how this industry developed, presenting the conceptual underpinnings of the health care industry while detailing its history and tracing the creation and entrenchment of the current federation of key stakeholders―government, insurance companies, hospitals, doctors, employers, and drug and device manufacturers. In the final section of the book, Dr. Guzick looks to the future, describing the prevention, innovation, and alternative financing models that could help to rebalance the priorities of care, cost, and access that Americans need.

An online supplement on COVID-19 is available, as is a discussion guide for instructors. To access this supplemental material, please visit www.jhupbooks.press.jhu.edu.

David S. Guzick, MD, PhD, a former senior vice president for health affairs and the president of UF Health, is a professor of obstetrics-gynecology and health services research and management at the University of Florida.