Plain English with Derek Thompson

Why American Health Care Is a "Broken System"


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Last week, UnitedHealthcare CEO Brian Thompson was shot to death outside a hotel in Manhattan by a young man motivated by rage at the insurance industry. His rage is clearly felt widely. In the aftermath of the killing, many people seemed to delight in the man’s assassination. Their reaction was a grotesque illustration of something real: There is an enormous amount of anger and frustration about the state of American health care. And there ought to be. The U.S. is the most expensive health care system in the world, while for many people it delivers bad care at exorbitant prices.


But anger is not always a signal of accuracy. And while some of the most popular reasons to be furious at American health care are based on truth, many are based on misunderstandings and myths—especially about the insurance system.


This week, I wanted to present a calm and informed conversation with a health care expert to walk me through what I consider the biggest health care questions of the moment. Why are American health care costs so high? How much are insurers to blame? How do other countries handle health care differently? What can we learn from them? And what, if anything, should make us optimistic about the future of American health care?


Today we have two guests. First we have Jonathan Gruber, an economics professor at MIT and a key architect of several health care laws, including the 2006 Massachusetts health care reform and the Affordable Care Act. Jon walks me through the key drivers of health inflation and American anger at the health care system. The second, David Cutler, is an economics professor at Harvard who served as senior health care adviser for Barack Obama; he helps us think comparatively about the weaknesses and strengths of the U.S. health system and what reforms could help Americans live longer and healthier lives.


If you have questions, observations, or ideas for future episodes, email us at [email protected].


Host: Derek Thompson

Guests: Jonathan Gruber and David Cutler

Producer: Devon Baroldi

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