Co-authored by Sandro Galea, M.D., and Nason Maani, Ph.D.

When considering how we might improve healthcare, an industry that accounts for more than 17% of the country’s GDP, it might be worth recognizing that there is much about healthcare that is not working well. There is a vast literature about how we might improve healthcare delivery in the U.S. and recent writing about how we might cut healthcare costs — a central priority for creating a better healthcare system. It is no secret that U.S. healthcare — while world-leading in its ability to train physicians, lead biomedical research, and offer cutting-edge diagnoses and treatments — suffers from ballooning costs, fragmentation, and challenges with access and affordability for a large proportion of the population. Efforts to address such fundamental failings are complicated by vested interests of private insurance companies, private healthcare, and pharmaceutical companies, which wield disproportionate influence over policy, as compared to their influence in peer countries, and which continue to extract uniquely high profit margins from the U.S.

In the 2023-2024 election cycle alone, it is estimated that the pharmaceutical/health products industry spent $384,507,360 on lobbying. An Axios report based on an analysis of company financial filings by Public Citizen noted that in 2021, Americans were paying more for 20 blockbuster drugs than the rest of the world combined.

Payments in the form of inpatient or outpatient care........

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