How
can a nation with unmatched wealth and medical innovation also have the
highest health care costs and the poorest health outcomes among its
peers? In America's Wrong Turn: US Health Care in the Neoliberal Era
(Johns Hopkins University Press, 2026), Dr. John E. McDonough offers a
compelling explanation for this troubling puzzle of contemporary US life
and shows that this reality did not arise by accident.
Beginning
in the later twentieth century, a powerful political and economic
philosophy began to reshape the United States and continues to mold
the institutions that govern health care, insurance coverage, and
population health. Across four decades, the rise of neoliberal thinking
elevated privatization, deregulation, and profit maximization as guiding
principles for public policy. Dr. McDonough illustrates how these ideas
influenced medical care at every level, altering government roles,
accelerating consolidation, encouraging the financialization of
once-mission-driven sectors, and shifting the US health system's
priorities away from patients and communities. The consequences of these
changes include deepening inequality, eroded public health capacity,
and a growing burden of medical debt.
Synthesizing
history, policy analysis, and the lived realities of the American
health system, Dr. McDonough reveals how a national commitment to
economic freedom above all else
set the stage for today's dysfunctional health care system. Despite
today's crises, he also highlights emerging efforts that signal the
possibility of a new direction, one based on fairness, accountability,
and the restoration of health as a public value. America's Wrong Turn
offers a framework for understanding how the United States arrived at
this moment and what it will take to create a system worthy of the
people it serves.
This interview was conducted by Dr. Miranda Melcher whose book
focuses on post-conflict military integration, understanding treaty
negotiation and implementation in civil war contexts, with qualitative
analysis of the Angolan and Mozambican civil wars. You can find
Miranda’s interviews on New Books with Miranda Melcher, wherever you get your podcasts.
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