US health care is rife with high costs and deep inequities, and that’s no accident – a public health historian explains how the system was shaped to serve profit and politicians

A few years ago, a student in my history of public health course asked why her mother couldn’t afford insulin without insurance, despite having a full-time job. I told her what I’ve come to believe: The U.S. health care system was deliberately built this way.

People often hear that health care in America is dysfunctional – too expensive, too complex and too inequitable. But dysfunction implies failure. What if the real problem is that the system is functioning exactly as it was…