How a society ensures people can access medical care, and who pays — the most complex domestic policy domain in the United States, touching financing, delivery, insurance, labor, pharmaceutical economics, and federalism simultaneously
The United States spends approximately twice what comparable wealthy nations spend on healthcare per person and achieves worse outcomes on most population health metrics. This is not a medical mystery. It is a policy inheritance — the accumulated consequence of specific institutional decisions made over eight decades that constrain and shape every current debate.