Listen now (34 mins) | As this hour-long documentary explains US hospital care, and healthcare in sum, is largely volume-driven that over-emphasizes expensive specialty versus spending-efficient primary care. There exist few constraints on commercial healthcare pricing despite the fact hospital prices have little correlation to care quality or value, defined as outcomes achieved relative to spending. Prices also vary significantly - even within the same city. Healthcare today can be largely defined as a profit-maximizing business. Hospitals, and clinical care professionals as well, are geographically maldistributed and the problem is growing as safety net and rural hospitals continue to close. That healthcare by its very nature does not constitute a competitive market has been made worse by 1980s deregulation. As result, about a third of the 100 million adults in the U.S. with healthcare are in debt to hospitals. Healthcare delivery exhibits significant gaps in health equity and providers waste $10s of billions on administering a chaotic insurance plan marketplace. This discussion will remind listeners of my interview with Brian Alexander in June 2021 regarding his book, “The Hospital: Life, Death and Dollars in a Small American Town.”