[Review] Health care in the USA: money has become the mission

Despite extraordinary scientific and medical resources, the US health-care system underperforms. In this Review we consider the damage wrought by decades of market-based policies that have stimulated profit-seeking by insurers and health-care providers. Policy makers have subcontracted coverage under the public Medicaid and Medicare programmes for people with low incomes and those older than 64 years to private insurance firms—which now derive most of their revenues from those programmes—raising taxpayers’ costs and constricting patients’ care.