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Oxford University Press Publishes Professor Robert Field’s Study of ‘Free Market’ Health Care

Professor Robert Field

November 11, 2013

The government “takeover” of health care that critics attribute to Obamacare actually occurred decades ago, Professor Robert Field argues in a new book published by Oxford University Press.

Mother of Invention: How the Government Created ‘Free Market’ Health Care” traces longstanding government policies that have allowed free enterprise to shape health care delivery in the U.S.

In 2011, the book begins, the high-cholesterol drug Lipitor generated $125 billion in sales for Pfizer, the for-profit Hospital Corporation of American logged profits of $1.9 billion and private insurer United Health reaped earnings of $8.5 billion on revenues of $102 billion. That the three industries were able to reach those benchmarks reflected the support of “a silent partner,” Field wrote, namely the government.

“In essence, the government created American health care and maintains it in its present form,” Field wrote. “A series of programs, most enacted during the middle of the twentieth century, established regulatory structures and massive funding commitments that shape every major aspect of the health care system as we know it today.”

The book offers a detailed account of policies and government-funded programs that fueled a robust – if largely invisible – public-private partnership that promoted innovation and created the pharmaceutical industry, the hospital industry, the medical profession industry and the health insurance industry.

The vigor and complexity of the nation’s health care system have made it the largest and most costly in the world – and tremendously resistant to reform, Field noted.

Field wrote that a controversial component of the Affordable Care Act that President Obama signed into law was first promoted by President Nixon: the individual insurance mandate.

“A viable private market for individual health insurance that offers coverage to everyone can only function if all potential customers – both healthy and sick – participate,” Field said, explaining Nixon’s desire to promote an individual insurance mandate until the Watergate scandal drove him from office.

Cost pressures could soon lead the nation’s health system to “collapse of its own weight,” Field wrote, citing the need for the government to refine policies so that the health care system “can continue to grow but at a pace commensurate with our true health care needs and our capacity to support it.”

The book is “elegant, thoughtful, creative, meticulous, unsettling, irresistible, and required reading for both scholars and citizens, “ James Morone, the John Hazen White Professor of Political Science and Public Policy at Brown University, said in a review.

This is Field’s second book with Oxford University Press, which published “Health Care Regulation in America: Complexity, Confrontation and Compromise” in 2006.

Field directs the JD-Master of Public Health Program and holds a joint appointment as professor of health management and policy at the Drexel University School of Public Health.