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The U.S. Health Care System Is Terminally Broken

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  • Ready for Reform?

    Shannon Brownlee challenges Dr. Ezekiel Emanuel to identify why heath care today is ripe for reform when many past efforts to reboot the American system have failed.

  • Geisinger and Kaiser: Up to Scale?

    David Feinberg takes a page from his opponent’s book – literally – to make the argument that innovative organizations and leaders are already transforming the U.S. health care system, improving outcomes, and lowering costs.

  • Health Care Spending v. Community Needs

    Should health care companies be required to invest more in community services?

  • Silicon Valley vs. Rural Pennsylvania: Where to Invest in Health Care

    David Feinberg urges fellow health care CEO Robert Pearl to leave Silicon Valley and discusses how to transform local health care systems to meet patient needs.

  • Sustainable Spending?

    Ezekiel Emanuel discusses positive trends in health care incentives, including in Medicare and Medicaid.

  • Specialist v. Primary Care

    How can Americans living in rural areas get the care they need?

Debate Details

The U.S. Health Care System Is Terminally Broken

This debate was presented live at Transform, the annual conference of the Mayo Clinic Center for Innovation


The United States spends more on health care than any other nation, but the system remains woefully inefficient. Consumers are fed up with soaring costs and poor outcomes, insurers take issue with market instability, and providers lament rising barriers to quality care. And while government is forced to contend with enormous financial strain, employers fear that rising health care costs will impact wages and sap their competitive advantage. Have the structural shortcomings of America’s fragmented system put us on the road to total system failure? Do we need to design tomorrow’s health care on a clean slate, or can innovations to the existing health care framework jolt the system back to life?

The Debaters

For the motion

Shannon Brownlee

Shannon Brownlee

Visiting Scientist, Harvard School of Public Health & Sr. Vice President, Lown Institute

Shannon Brownlee is senior vice president of the Lown Institute and a visiting scientist at the Harvard T.H. Chan School of Public Health. She is... Read More

Dr. Robert Pearl

Dr. Robert Pearl

Fmr. CEO, The Permanente Medical Group

Robert Pearl, M.D., is one of the most influential physician leaders today, according to Modern Healthcare, and author of the bestselling book Mistreated... Read More

Against the motion

Dr. Ezekiel J. Emanuel

Bioethicist & Vice Provost for Global Initiatives, University of Pennsylvania

Ezekiel J. Emanuel, M.D., is an oncologist, author, and a senior fellow at the Center for American Progress. He was founding chair of the Department... Read More

David Feinberg

Dr. David T. Feinberg

President & CEO, Geisinger

David T. Feinberg, M.D., MBA, is president and CEO of Geisinger, one of the nation’s largest health services organizations known for reinventing... Read More

Where Do You Stand?

For The Motion
  • The American health care system was built for profit. Doing away with the financial incentives that drive skyrocketing costs and limit patient outcomes will require total system overhaul.
  • Given deeply entrenched special interest groups, lawmakers are unlikely to make the drastic -- and costly -- changes necessary to fix American health care.
  • Americans have grown accustomed to lackluster care. Without widespread consumer demand for market overhaul, Americans will continue paying more and receiving less.
  • The United States health care system is outdated and deeply fragmented. True reform would require widespread modernization and integration and a rebuke of current practices.  
Against The Motion
  • Seeking a complete remodel of the existing heath care system wastes valuable time and resources. American consumers would be better served by targeted regulations that reign in abuses and set the marketplace on a course for success.
  • With a few incremental policy changes, such as expanding the insurance market through mandatory enrollment and cost offsets for low-income buyers, the United States can provide affordable, quality health care without overhauling its existing system. 
  • The power of special interest groups may be declining. Given widespread demand for affordable care, lawmakers will soon have no choice but to act on health reforms or lose elections.
  • Innovative medical professionals, administrators and providers alike, are already enacting meaningful changes within their own organizations. They prove that quality care, at affordable costs, is possible. 

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The Research

The Research

5 Myths About Our Ailing Health-Care System

November 23, 2008

With Congress ready to spend $700 billion to prop up the U.S. economy, enacting health-care reform may seem about as likely as the Dow hitting 10,000 again before the end of the year. But it may be more doable than you think, provided we dispel a few myths about how health care works and how much reform Americans are willing to stomach.

Why Do Health Costs Keep Rising? These People Know

June 9, 2016

The Geisinger Health Plan, run by one of the nation’s top-rated health care organizations, foresees medical costs increasing next year by 7.5 percent for people buying insurance under the Affordable Care Act.

Obamacare architect: We need to fix some of our mistakes that led to soaring costs

August 1, 2017

Republicans and Democrats need to put politics aside to tweak urgent problems, Dr. Ezekiel Emanuel says.

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