In a new STAT First Opinion debate, two longtime health policy experts, John E. McDonough and Stuart Butler, take on the roots of America's health care problems. McDonough, author of "America's Wrong Turn: U.S. Healthcare in the Neoliberal Era," argues that seemingly separate issues—high deductibles, medical debt, private equity takeovers, and market consolidation—are actually interconnected. The common thread, he says, is neoliberalism, a political-economic movement championed by Milton Friedman that rose to prominence in the Reagan era.
Butler, a Brookings Institution scholar and former Heritage Foundation staffer, pushes back on that framing. He says McDonough's book exaggerates differences and misrepresents the people it attacks. Yet Butler also concedes that he agrees with the principle that everyone should have access to affordable health care, and he largely endorses the way forward McDonough proposes at the end of the book.
The two experts have collaborated across party lines for years, including on Massachusetts health reform and the individual mandate that later became part of the Affordable Care Act. Their exchange is the first installment of STAT's "Friendly Argument" series, which aims to model productive disagreement on health policy.