The U.S. healthcare system is dysfunctional, one that rewards the wrong things and doesn't create value for the consumer.

The United States has a system with the wrong kind of competition, on the wrong things. Instead, we have a zero-sum competition to restrict services, assemble bargaining power, shift the cost to others, or grab more of the revenue versus other actors in the system.

Zero-sum competition does not create value; it can actually destroy value by adding administrative costs and leads to structures involving health plans and providers and other actors, which are misaligned with patient value. In a world of zero-sum competition, for example, providers will consolidate into provider groups to gain clout against insurers. But, as we point out in our book, the provider group doesn't create any value. Value is not created by breadth of services but excellence in particular medical conditions.

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