It didn’t always cost this much and deliver this little. Something broke in the early 1980s—and in AMERICA’S WRONG TURN: US Health Care in the Neoliberal Era (Johns Hopkins University Press, August 11, 2026 . You can use Promo-Code of HTWN at checkout to get 30% discount ), John E. McDonough explains exactly what it was.

The failings of the American healthcare system didn’t happen by accident. They happened because its already sprawling, fragmented structure—Medicare, Medicaid, employer-sponsored insurance, the VA, and more—left it uniquely exposed to a de-regulatory wave that moved fast and largely out of public view. A bedrock faith in free markets was let into the hen house, and the results are stark: the U.S. now spends more and delivers worse outcomes than any other wealthy nation on earth.

John McDonough watched neo-liberal economic agenda reshape American political thinking—often without recognizing the seismic nature of the shift in the moment. Its narrow focus on economic and business interests altered government’s role, drove consolidation across industries, deregulated the healthcare sector, and shifted corporate priorities away from consumer benefit and toward shareholder returns. [ dur: 36 mins. ]

• John McDonough is a professor at the Harvard T.H. Chan School of Public Health and a former Massachusetts state legislator who served thirteen years in the 1980s and 1990s as neo-liberalism was overtaking American political life. He has also co-authored Overcoming the Digital Divide in Health Care AI.

Then, many observers argue, that the economic forces are corrupting medical care and eroding the trust between patients and their doctors. The problems in health care delivery have wide implications related to how health care should function particularly when there are limited resources. We examine the ethics of medicine and healthcare, and the modern day issues that complicate them. [ dur: 22 mins. ]

Note: this segment is an excerpt from interview recorded on January 16, 2015. The complete version can be found here.

• Thomas Pogge is the Director of the Global Justice Program and Professor of Philosophy and International Affairs at Yale University. His books include World Poverty and Human Rights and Freedom from Poverty: Who Owes What to the Very Poor?.
• Martin Wilkinson is Professor of Politics and International Relations at the University of Auckland. His books include Freedom, Efficiency and Equality and Ethics and the Acquisition of Organs.
• Richard Cookson is Professor at the Centre for Health Economics, and Co-Director of the Equity in Health Policy (Equipol) research group at the University of York. His books include The Humble Economist: Tony Culyer on Health, Health Care and Social Decision Making and Jonathan Bradshaw on Social Policy: Selected Writings 1972-2011.

This program is produced by Ankine Aghassian, Doug Becker and Sudd Dongre.

Health, Politics and Activism, Healthcare Industry, Medicine, neo-liberal economics

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