Corporatizing american health care: How we lost our health care system Robert Derlet Baltimore, MD, John Hopkins University Press, 2021c. $29.95. Paperback pp. 216. ISBN: 9781421439587

• Published date: 01 March 2023
• Author: Preshit N. Ambade
• Date: 01 March 2023
• DOI: http://doi.org/10.1002/wmh3.511

DOI: 10.1002/wmh3.511

BOOK REVIEW

Corporatizing american health care: How we

lost our health care system

Robert Derlet

Baltimore, MD, John Hopkins University Press, 2021c. $29.95. Paperback pp. 216. ISBN: 9781421439587

Robert Derlet's book “Corporatizing American Health Care: How We Lost Our Health Care

System”is an excellent contemporary solution‐oriented overview of the systemic causes

behind the rising costs in US Health care. It is a physician's account of the evolutionary story

of American health care. From the outset, Derlet's message is clear: “The driving forces that

result in outrageous health care costs in America can only be solved by legislation by the US

Congress”(p. 4). Backed up with both data and anecdotal evidence, he explains how

American healthcare has evolved as a corporate profit‐making machine from a bedside

clinical practice.

According to Derlet, one needs to consider biomedical, behavioral, and political economy

models to understand the causes of health (or ill health) in the public health scholarship

(Birn et al., 2017). Under the political economy of health framework, as Birnet al. (2017)

define it, health is “…a result of social, political, and economic structures and relations that

constrain your control over stressful situations and work environment and limit your access

to health care, recreation, housing, education, and good nutrition. …” (paraphrasing Hervik

& Thurston, 2016). Though not comprehensively, Derlet's book discusses a few systemic

and structural causes behind the rising healthcare costs in the United States.

Consider prescription drugs prices. After reviewing relevant acts and regulations,

Derlet details the monopolistic tricks adopted by the pharmaceutical industry to earn

enormous profits. With lucid examples, he explains how the pharma industry takes

advantage of loopholes in patent laws, colludes with other partners, undercuts

competitors, hides information from physicians, holds hostage health plans for payments,

spreads misinformation via media campaigns, and engages in price‐fixing. The Pharma

and health industry spends nearly $300 million lobbying US Congress to protect their

business interests and practices. The author argues that such intense lobbying prevents

the legislature from taking concrete steps to curb drug prices. He prescribes election

campaign finance reforms, prohibiting lobbying by the pharma/health industry, reforms in

patent laws, learning from other health systems, and in‐depth cost–benefit analysis of the

drugs as solutions (pp. 6–24).

Hospitals have developed a monopolistic business model too. Activities that drive up the

hospital costs include price gauging, overprescribing tests and procedures, dubious fee

scheduling, profit‐oriented management, unnecessary development projects, billing errors,

fraudulent activities to usurp more money from Medicare, and out‐of‐pocket, and crushing

down rural hospitals. Due to the current monopolistic state of the hospital business, “the

hospital costs represent over 30% of US healthcare dollar, about $4000 for each man,

woman, and child in this country”(p. 34). According to Derlet, again, the responsibility to

control rising hospital costs rests upon Congress.

World Medical & Health Policy. 2023;15:98–100.wileyonlinelibrary.com/journal/wmh398

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