“As economic inequality in the USA has deepened, so too has inequality in health”(Dickman 1431)
As someone who is a firm believer in capitalism, it naturally makes sense to me that the different sectors of our economy, like healthcare, should be able to function properly under a capitalistic model. However, when reflecting on our course, it is clear that our capitalist market has led to some gaps, particularly in regards to medical care. We can see these gaps in the inequalities across different races, wealth groups, and genders and while I still believe that capitalism is the best market structure, I think it struggles to work the way that it should in the case of medicine. Our society has likely overextended capitalism, and we may need to seriously reconsider if it is the best structure for medicine.
Capitalism in the Current Structure of Healthcare
Currently, the U.S. healthcare system is composed of a mixture of public and private insurers and health care providers, some of which operate for-profit and some nonprofit (Tikkanen). The U.S healthcare system also includes government sponsored programs, like Medicare and Medicaid, that help groups receive medical care. As of 2018, 92 percent of the U.S. population was estimated to have insurance coverage, which leaves “27.5 million people or 8.5 percent of the population uninsured” (Tikkanen). Part of this lack of insurance can be attributed to the rise in healthcare expenses as costs in the U.S. grow between 4.2 percent and 5.8 percent annually (Tikkanen). Because of the capitalist structure, medical care in the U.S. functions almost like a monopoly, instead of perfect competition, where costs can continually rise unopposed as medical providers and insurance companies control the market.
Negative Effects of Capitalism
As mentioned, the evidence as to why a capitalist market does not work well in regards to medicine is seen when looking at the disparities across racial groups, wealth, and gender. Based on our current model, many people need to work to gain insurance and afford medical care. However, this pressures people to continue working even when they are sick. During the COVID-19 pandemic, certain essential workers were deemed so necessary to our economic function, that they could not stop working. In most of these instances, these essential workers were racial minorities. Our extreme focus on production and economic growth has led to “Latinx food and agriculture workers [experiencing] a nearly 60% increase in deaths compared to prior years” (Maxmen). Because we want to continuously grow, we have let the medical needs of workers shift to the background, which has disproportionately affected people of different races. Thus, the capitalist model has led to a large gap in medical care for certain groups.
The negative side effects of capitalism in healthcare can again be seen in wealth disparities. The large economic inequality in the U.S. has now bled into health disparities as wealthier Americans have a life expectancy that is now ten to fifteen years longer than poor Americans (Dickman 1431). Geography has played a large role in this as many health care providers work in cities or larger suburbs (Dickman 1434). This follows basic supply and demand functionality in capitalism. The increased demand for healthcare in more densely populated areas, coupled with the higher likelihood of patients being able to afford care or obtain their own private insurance, has led to the greater supply of doctors in these areas. Yet, there is still a large population of people who need medical care in more rural areas, which demonstrates that a capitalist market may not be the most efficient when it comes to healthcare.
Capitalism in medicine has even extended into the creation of products and marketing campaigns to deal with natural body processes, especially for women. This is evident in the creation of hormone treatments and medications to help women during menopause. Many feminists view this as “a superfluous product designed to keep women sexually available and conventionally attractive” (Dominus). Because we have allowed a capitalist structure to take over medicine and medical treatments, large industries have developed with products claiming to solve all sorts of problems (Dominus). While some of the extension of capitalism has created medications that are truly helpful, like the F.D.A.-approved hormone therapy for women, it has also led to greater inequalities between genders. There are significantly larger pressures on women to maintain physical appearance and be healthy, and yet many female issues are still not well understood. Despite this, the market of medicine has created products and industries to “alleviate” these differences.
Clearly, by allowing a capitalist market structure to control the medical field, we have allowed gaps in care and inequalities to fester. When reflecting on these issues, it certainly brings a lot to mind for me. Prior to this course, I would firmly stand behind a capitalist structure as the best way for the healthcare system to function. However, now, I am not sure that is true. Nevertheless, changing the current operations of the system would likely take a major overhaul – possibly exacerbating the issues mentioned above. While it is likely best to move towards more universal medical care, it will be extremely difficult in our profit and opportunity seeking society. Even if we cannot make any direct changes to the market structure of medicine right now, at least drawing attention to the issues that the capitalist structure has created will help begin to possibly resolve them.
Dickman, Samuel L., David U. Himmelstein, and Steffie Woolhandler. “Inequality and the health-care system in the USA.” The Lancet 389.10077 (2017): 1431-1441.
Dominus, Susan. “Women Have Been Misled about Menopause.” The New York Times, The New York Times, 1 Feb. 2023, https://www.nytimes.com/2023/02/01/magazine/menopause-hot-flashes-hormone-therapy.html.
Maxmen, Amy. “Inequality’s Deadly Toll.” Nature News, Nature Publishing Group, 28 Apr. 2021, https://www.nature.com/immersive/d41586-021-00943-x/index.html.
Tikkanen, Roosa, et al. “United States.” International Health Care System Profiles: United States, The Commonwealth Fund, 5 June 2020,