What the Pandemic Taught Us: The Health Care System We Have Is Not the System We Hoped We Had

The United States spends nearly twice as much per capita on medical care as any other country. The United States has the world’s most advanced biomedical technologies, sophisticated hospitals, and skilled health professionals. The United States has a national public health body, the Centers for Disease Control and Prevention (CDC), that is generally considered the world’s leader in infectious disease detection and response. Nonetheless, the United States suffered among the world’s worst COVID-19 disease burdens and outcomes, inflicting largely avoidable harm on patients, health professionals, and the broader community.Why this happened is clearly important. But that it happened is itself significant. Criticisms of the U.S. health care system abound, but often have a Lake Wobegon character: The “health care system” may be bad, but my personal doctor is good. A silver lining of the pandemic experience is the possibility that Americans will finally recognize that, whether or not one’s own doctor is in fact good, American health care is unreliable, wasteful, and unjust. Should this occur, the path forward should combine several issues of law and policy to which I have devoted much of my scholarly career. These include improving corporate governance, rethinking professional ethics and selfregulation, remaking health care delivery, and broadening competition policy— with the common objective of enhancing collective goals and obligations in U.S. health policy