Forbes April 15, 2025
Kevin Vigilante

When I was a medical student in 1983, I wrote my senior thesis on healthcare costs. They had been steadily rising for over 20 years and, at about $355 billion or 11% of GDP, seemed out of control. Forty years later, despite multiple interventions—from managed competition to value-based care—healthcare costs continue to climb. In 2023, the U.S. spent almost $4.9 trillion—about 18% of the GDP—on healthcare, making the costs I previously fretted over seem quaint. And although other OECD countries spend less than we do, their cost curves look similar.

It seems like healthcare has an incurable “cost disease.”

Economist William Baumol saw it exactly this way. Studying the economics of the arts, he observed that musicians in the 1960s...

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