Explaining America's Spendthrift Health Care System: The Enduring Effects of Public Regulation on Private Competition

Forthcoming 2019 in J. Boertjens et al., eds., Healthcare Finance (Edward Elgar Pub.)

U of Texas Law, Law and Econ Research Paper

U of Texas Law, Public Law Research Paper 581

16 Pages Posted: 27 Jul 2018

See all articles by William M. Sage

William M. Sage

University of Texas at Austin School of Law; University of Texas at Austin - Dell Medical School

Date Written: July 25, 2018

Abstract

The United States is often described as the only developed nation without a public commitment to universal health care. Instead, its health care system is widely considered a product of bio-scientific free enterprise – technologically sophisticated, extremely expensive, but inaccessible to the poor. This chapter offers a contrasting account, refuting the conventional narrative of U.S. health policy as private, competitive, and entrepreneurial. Beginning over 20 years ago, the poor performance of the American health care system has been slowly revealed. For nearly as long, steps that might improve that performance have been identified. But little has changed. Why? The answer, in large part, lies in an accumulation of laws, regulations, self-regulatory practices, and financial subsidies which locks US health care into inefficient, unfair patterns and practices. While most of these provisions were well-intentioned when put into place, this “deep legal architecture” now serves mainly to prevent meaningful competition in medical markets and to distort or limit collective investment in the nation’s health.

Keywords: healthcare, health reform, Affordable Care Act, health law

JEL Classification: I11, I18, K32

Suggested Citation

Sage, William Matthew, Explaining America's Spendthrift Health Care System: The Enduring Effects of Public Regulation on Private Competition (July 25, 2018). Forthcoming 2019 in J. Boertjens et al., eds., Healthcare Finance (Edward Elgar Pub.) ; U of Texas Law, Law and Econ Research Paper; U of Texas Law, Public Law Research Paper 581. Available at SSRN: https://ssrn.com/abstract=3220164

William Matthew Sage (Contact Author)

University of Texas at Austin School of Law ( email )

727 East Dean Keeton Street
Austin, TX 78705
United States

University of Texas at Austin - Dell Medical School ( email )

Austin, TX 78712

Register to save articles to
your library

Register

Paper statistics

Downloads
49
Abstract Views
116
PlumX