• Jonathan Gruber, professor of economics, MacVicar Faculty Fellow

    Photo: Jon Sachs

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  • Andrea Campbell, the Hayes Career Development Associate Professor in the Department of Political Science

    Photo: Jon Sachs

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  • David Jones, MD, associate professor in the Program in Science, Technology, and Society

    Photo: Jon Sachs

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  • Erica James, associate professor of anthropology

    Photo: Jon Sachs

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“Diagnosing” the U.S. health care system: in Soundings Magazine

The U.S. health system has been ranked second in the world in expenditures — and 38th in the world for performance. What's going on?

In sickness and in health, the United States is a nation of extremes, paying more for health care — and getting less health in return — than almost any other country in the world. Faculty in MIT School of Humanities, Arts, and Social Sciences have spent years investigating the economic, political and social implications of our current system — and ways to improve it.

As Congress moves toward enacting historic U.S. health system reform legislation, four school experts — David Jones, M.D.; Andrea Campbell; Erica James; and Jonathan Gruber — continue to provide deep perspective on why America has the system it has, and what will, and will not, work to create more health — both for “We, the People,” and for the national pocketbook. 


"This is an extraordinarily wealthy country," says Jones, a physician and Associate Professor of the History and Culture of Science and Technology in the Program in Science, Technology, and Society.  

"The ability of the country to generate hundreds of billions of dollars for a war in Iraq over the past 10 years and to generate hundreds of billions of dollars for bailouts — dollars people didn’t realize were available — suggests that if we wanted to fully fund a health care system, we do have the resources. Our current system reflects our national priorities," he says. “When there is political will or perceived necessity, resources are made available."

And yet, as a country, we’re already spending a fortune on health care.

“If health care spending continues on its current trajectory, by 2050 health care will be 50 percent of our economy,” says Andrea Campbell, associate professor of political science. She points out that spending is currently growing 2.5 percent faster than growth in gross domestic product, a pace that is unsustainable.

So why aren’t we getting better results?

Read the full article in Soundings Magazine, Fall 09 edition.

Key quotes from the article:  

  • “Ironically, American’s collective unwillingness to pay for universal health care costs the country dearly. Without good preventive care, America’s 43.6 million uninsured must often resort to emergency and acute care — the most expensive types of medical treatment."
  • “It would be much cheaper to provide primary care rather than waiting until people present to emergency rooms,” David Jones says. “I think that if we provided care to everyone, costs would come down."
  • “Universal coverage in America is expected to cost $1 trillion over 10 years — not a small amount, but a figure equivalent to the amount health care costs rise each year, according to Jonathan Gruber, Professor of Economics. “Think about it, we could cover all the uninsured in America for the cost of one year’s growth in cost,” he says.
  • The current system of employer-sponsored health insurance also effectively locks people into their jobs, strangling entrepreneurship, Gruber observes.
  • Campbell, Gruber, and Jones all say they would like to see a public option included in any national health care reform legislation. “I think it would outperform private insurance,” Jones says.
  • Be that as it may, it’s clear the United States is not going to nationalize a $500 billion industry, Gruber says. “If you think about steps toward cost control in America, there are easy steps and there are harder steps,” he says. Starting with universal coverage will give everyone a stake in controlling costs going forward, he says.

Topics: Anthropology, Economics, Health, Humanities, Policy, Political science, Technology and society


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