Big Med

Megaproviders and the High Cost of Health Care in America

David Dranove and Lawton Robert Burns

Big Med

David Dranove and Lawton Robert Burns

336 pages | 2 figures, 3 tables | 6 x 9 | © 2021
Cloth $35.00 ISBN: 9780226668079 Will Publish April 2021
E-book $35.00 ISBN: 9780226756844 Will Publish April 2021
There is little debate that healthcare in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders—the expansive healthcare organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And both are bad news for your health and your wallet.

Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s followed by their swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, delivering on none of their early promises. For patients, this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms.

In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of healthcare has been corrupted and submerged under consolidation. They offer practical recommendations for enhancing competition policy reforming megaproviders to actually achieve the efficiencies and quality improvements these organizations have long promised.
 This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
Review Quotes
David Cutler, Harvard University
“For years, allies of big medicine have argued that Bigger is Better. Dranove and Burns take on that argument and show it is not true. They point out how big medicine is failing, and how it can be reformed. This book is wonderfully informed and thoughtfully presented.”
Leemore Dafny, Harvard Business School
“Incorporating tough-minded analysis with powerful rhetoric, this book describes why the US healthcare delivery system fails us, why mergers are unlikely to help, and what industry and policy leaders can do to turn things around.”
 
Melissa Thomasson, Julian Lange Professor of Economics at Miami University and research associate for the National Bureau of Economic Research
Big Med is an absolute treasure trove of health care antitrust history, offering an important overview of the last two decades of the US health care industry through a competition lens. Its findings will appeal to health systems leaders and health economists alike.”
 
For more information, or to order this book, please visit https://press.uchicago.edu
Google preview here

Chicago Manual of Style

Keep Informed

JOURNALs