The Business Of American Healthcare: Why It Works And Who It Works For

The Business of American Healthcare: Why It Works and Who It Works For is a wide-ranging examination of one of the most innovative, expensive, and unequal healthcare systems in the world. The United States produces extraordinary medical breakthroughs.

Its hospitals, research institutions, pharmaceutical companies, physicians, and biotechnology firms have developed treatments that extend lives and transform diseases once considered untreatable.

Yet this same system leaves millions of people struggling with denied coverage, unaffordable insurance, medical debt, limited provider networks, and unequal access to care. Ángel Marqués explores this contradiction by asking a direct question: if the system works, who does it work for?

The book traces the historical transformation of American healthcare from a largely charitable and community-based service into a vast commercial industry.

It examines the rise of private medical practice, employer-sponsored insurance, Medicare, Medicaid, managed care, hospital consolidation, pharmaceutical power, and the expanding role of insurance corporations.

Rather than treating the healthcare crisis as the result of a single political party, company, or policy, Marqués shows how the system developed through layers of historical compromise, economic incentives, cultural values, and political conflict.

The result is not one unified model, but a fragmented structure in which public programs, private insurers, employers, hospitals, pharmaceutical companies, and patients operate under different rules and competing priorities.

The book explores: The early history of healthcare before it became a large-scale business The growth of employer-sponsored insurance after World War II The creation and long-term impact of Medicare and Medicaid The rise of insurance companies, hospital systems, and pharmaceutical corporations The financial relationship between patients, providers, insurers, and government The inequalities created by income, race, employme