The American Health Care Paradox: Why Spending More is Getting Us Less by Elizabeth H. Bradley, Lauren A Taylor

In her latest book The American Health Care Paradox: Why Spending More is Getting Us Less, Elizabeth H. Bradley tackles one of the most pressing issues of our time: how the United States is spending more on health care yet getting less in return in terms of health outcomes. By delving deeply into the disparities in access and outcomes within our health system, Bradley reveals the systemic injustices that perpetuate this paradox.

Looking beyond the headlines, Bradley explores the history of health care in the United States and what we can learn from other nations that have achieved better outcomes despite spending less. She argues that the most basic problem is a lack of inclusion of all members of society in access to care, in which people with financial means are provided superior health care due to the power of their wallets over those without those means. Not only does inequity lead to worse outcomes for those without access to care, it also leads to increased financial and economic costs for society. She ties this together by noting that economic costs are also caused by the over-treatment of those with access due to incentives in the market, diverting more resources away from more effective prevention efforts.

In addition to addressing the roots of the inequity in our system, Bradley puts forth an actionable policy agenda to make meaningful progress. She acknowledges that top-down solutions are not going to solve the problems, so instead she encourages bottom-up solutions grounded in equitable access to care, and meaningful investment in effective prevention. She proposes a number of policies to do this, such as streamlined delivery of care, increasing access to affordable preventive services, shifting resources towards primary care, and investing in community development.

Next, Bradley takes a hard look at how public opinion affects policy decisions and how people have been misled by popularly-held false beliefs and myths. She argues that health care has become too much a political topic, leading to decisions made for the wrong reasons, such as for-profit motives and adherence to party lines. She explains that it is necessary for our society to become better educated about the real problems that face health care, and for members of certain populations and communities to become empowered to demand change.

In all, The American Health Care Paradox: Why Spending More is Getting Us Less provides an insightful, big-picture analysis of why our health system is not only failed to deliver adequate health outcomes, but why it continues to be stuck in a cycle of inefficiency, inequity, and irresponsibility. By laying out the facts and possibilities for change, Bradley makes a powerful argument for why we should break this cycle and invest in system-wide change for the better of all members of society. Her actionable policy proposals and suggestions for the public to become educated and engaged in the dialogue make this an important read for anyone looking to understand the current state of health care in the United States and the possible paths to change.