The American Health Care Paradox

Foreword by Harvey V. Fineberg, President of the Institute of Medicine

For decades, experts have puzzled over why the US spends more on health care but suffers poorer outcomes than other industrialized nations. Now Elizabeth H. Bradley and Lauren A. Taylor marshal extensive research, including a comparative study of health care data from thirty countries, and get to the root of this paradox: We’ve left out of our tally the most impactful expenditures countries make to improve the health of their populations—investments in social services.

In The American Health Care Paradox, Bradley and Taylor illuminate how narrow definitions of “health care,” archaic divisions in the distribution of health and social services, and our allergy to government programs combine to create needless suffering in individual lives, even as health care spending continues to soar. They show us how and why the US health care “system” developed as it did; examine the constraints on, and possibilities for, reform; and profile inspiring new initiatives from around the world.

Offering a unique and clarifying perspective on the problems the Affordable Care Act won’t solve, this book also points a new way forward.