In the United States, healthcare is far more expensive than all other wealthy nations, and it ranks poorly in most measures of population health. In 2024, healthcare expenditures in the US were $15,000 per person (constituting 18% of the GDP). That same year, Canada’s expenditures were half that ($7,500 and 12.2% of GDP). Yet in 1970, both countries were spending the same proportion of GDP on healthcare—about 6.25%. Join us to examine what has happened to make healthcare so expensive in the US over the past 55 years. Through historical analysis and discussion of evidence from the economic literature, we explore how hospital systems, insurance structures, physician practices and public policy have contributed to today’s cost imbalance—and what might be done about it.

• Week 1: An overview of the US healthcare system and its cost anomaly
• Week 2: Historical roots of provider market power and health insurance development
• Week 3: A tale of two systems—US and Canada
• Week 4: Core mechanisms driving cost—private insurance and non-profit hospital behavior
• Week 5: Assessing a landmark intervention-the Affordable Care Act (Obamacare)
• Week 6: The path forward—proposed policy solutions