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The Conversation
The Conversation
Patrick Aguilar, Managing Director of Health, Washington University in St. Louis

Why is US health care still the most expensive in the world after decades of cost-cutting initiatives?

Two-thirds of Americans are very worried about being able to pay for their health care. Morsa Images/DigitalVision via Getty Images

In announcing its “Great Healthcare Plan” in January 2026, the Trump administration became the latest in a long history of efforts by the U.S. government to rein in the soaring cost of health care.

As a physician and professor studying the intersection of business and health, I know that the challenges in reforming the sprawling U.S. health care system are immense. That’s partly for political and even philosophical reasons.

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