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Hospitals and Healthcare: From Sanatoriums for the Indigent to Citadels of the Elite.

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The third and final installment of our American Healthcare series examines the evolution of the American hospital system. There are more than 6,000 hospitals in the United States and several distinctions among them. After a quick recap of the first two episodes, we look primarily at the peculiar designation of nonprofit hospitals, their relationship to practitioners and their role in driving costs in the system. We conclude the series with a few hot takes from medical professionals, some basic proposals to improve coverage and care and ask what it would take to move toward Medicare for All.


Intro: 00:01:59

Chapter One: What’s a Hospital? 00:13:59

Chapter Two: For-Profit and Nonprofit Hospitals. Two sides of the same damn coin. 00:17:56

Chapter Three: Turning Doctors into Business People. 00:31:07

Chapter Four: Bring it home, Max. 00:36:09

Post Show Musings: 00:50:39

Book Love: 01:10:43

Outro: 01:11:11


OECD.stat: Health Care Resources: Hospitals

EOS Surfaces: Types of Hospitals in the US

AAPC: What Are Relative Value Units (RVUs)?

American Hospital Association: Fast Facts on U.S. Hospitals, 2022

Becker’s Hospital Review: 82 Physician-Owned Hospitals to Know

AMA Journal of Ethics: Physician-Owned Hospitals and Self-Referral

NPR’s Planet Money: How Non-Profit Hospitals Are Driving Up The Cost Of Health Care

LWW Journals: The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System

Weatherby Healthcare: Physician salary report 2022: Physician income rising again

The New York Times: Why Are Nonprofit Hospitals So Highly Profitable?

Hub’s List: A data-based biweekly newsletter of medical fun facts

The New England Journal of Medicine: Practicing Medicine in the New Business Climate

The New England Journal of Medicine: Is Quality Improvement Improving Quality? A View from the Doctor's Office

CNN: 2 charts that show just how old this Congress actually is

The Commonwealth Fund: International Health Care System Profiles- France

Germany Visa: Health Insurance in Germany- The German Healthcare System

Congress.gov: H.R.1 For the People Act

NASHP: Can We Please Stop Fixating on Hospital Chargemasters?

KHN: Nixon’s Plan For Health Reform, In His Own Words

CBO: Estimated Budgetary Effects of Title I, Committee on Finance, of H.R. 5376, the Inflation Reduction Act of 2022

The Lever: Where Did The Public Option Go?

UNFTR Episode Resources

U.S. Healthcare.

This Healthcare is Killing Us.

Student Debt.

Book Love

Paul Starr: The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry

Steven Brill: America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System

Nelson Lichtenstein: State of the Union: A Century of American Labor

Mark Vonnegut: The Heart of Caring: A Life in Pediatrics


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Unf*cking the Republic is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com). The show is written by pre-existing conditions and hosted by declining mortality rates.

Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic."

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Unf*cking The Republic (UNFTR)

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