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The Dartmouth
July 16, 2025 | Latest Issue
The Dartmouth

Prof. criticizes U.S. health care model

Correction appended

Successful health care reform would be a major turning point in United States history, with repercussions similar to those of the Industrial Revolution, Harvard Business School professor Regina Herzlinger said in a lecture on Tuesday at Dartmouth-Hitchcock Medical Center. Herzlinger proposed increasing health care plans' transparency and abolishing employer-based insurance during her lecture, "Who Killed Health Care?"

"What happened with the Industrial Revolution is that a set of technologies came about that fundamentally transformed human life," Herzlinger said.

A consumer-based health care system, focused on personalized medicine, would lower insurance costs enough to make insurance accessible to everyone, Herzlinger said, similarly transforming the way we live.

"We have half a trillion dollars of waste every year," she said. "If we could squeeze out this waste, that would be more than enough to insure the uninsured without any new taxes."

Herzlinger said the current health care system is ineffective and unnecessarily costly, and decreases the country's global competitiveness.

"Nearly 300,000 people are killed by hospital errors every three years," Herzlinger said. "So most people know that when they go to a hospital, they need to take someone who cares about them, who will act on their behalf, who is not only loving but also intelligent. In any other industry this kind of statistic would be shocking in and of itself, and to have it repeated year after year would be unthinkable."

Herzlinger proposed ending the practice of docking workers' salary to fund an employer-based health care plan. A consumer-driven approach to health care reform would cut costs and increase the transparency of health insurance options, she said.

The current system of employer-provided insurance, which is particular to the United States, originated from massive inflation after World War II, rather than from systematic thought about how to structure health care, Herzlinger said.

"The president at that time, Harry Truman, declared wage and price controls, so that companies that wanted to hire workers could not offer them more money," she said. "So the businesses thought, You know what, we can offer people health insurance it's very cheap.'"

The problems associated with employer-provided insurance are exacerbated by many small companies' inability to provide health insurance for its employees, Herzlinger said.

Because the majority of available new jobs are with small start-up companies that cannot afford to provide coverage, health care reform is critical, she said.

Herzlinger cited Switzerland's health care model, which requires everyone to purchase insurance, as a cost-effective way to reduce insurance companies' incentives to discriminate against people with preexisting conditions.

The system is transparent and competitive, as the country has 86 insurers to choose from, allowing citizens to choose the health care plans that suits them the best, Herzlinger said. Consumers in the system, she said, can switch insurers every six months.

In response to a question from the audience, Herzlinger said she does not believe Congress' health care reform efforts will end employer-based health care. Instead, she said, it is more likely that Congress will expand Medicaid.

**The original version of this article incorrectly identified citizens of Switzerland as Swedes, rather than Swiss.*