US healthcare needs fixing, but there's no agreement on how to do it

The US has one of the most expensive health systems in the world, with spending on health care estimated to reach $5.9tn (£4.3tn) in 2026, according to the Centers for Medicare and Medicaid Services. But despite spending twice as much per capita on healthcare compared with wealthy nations of a similar size, the US has a lower life expectancy than those other nations, according to health research nonprofit KFF.

Large publicly-traded health companies have tripled their profits over the last two decades, paying out shareholders over $2.6tn from 2001 to 2022, according to a study in the Journal of the American Medical Association. "We are the only major [health] system in the world that allows the free market to run loose," said John McDonough, Harvard TH Chan School of Public Health professor.

Roughly one in five Americans covered by private health insurance reported their provider refused to pay for care recommended by a doctor in 2023, according to a survey by KFF.

The number of overlapping health care systems in the US - Medicare, Medicaid, the marketplace, employer-sponsored insurance and veteran's health, among others - creates a confusing and sometimes wasteful system, said McDonough. "We have so many, each of them with their own set of rules, their own system, their own bureaucracy," he said. "We really do need some system consolidation."