Healthcare costs keep rising because trade-offs are unavoidable. Dr. Aaron Carroll explains pricing, policy, insurance limits, and global healthcare systems.

In this episode of Analyzing Healthcare, host Roy Bejarano, CEO & Co-Founder of SCALE Healthcare, sits down with Dr. Aaron E. Carroll, President & CEO of AcademyHealth, to unpack why U.S. healthcare remains the most expensive system in the world—and why no reform comes without painful trade-offs.

Drawing on decades of health services research and policy leadership, Dr. Carroll explains why rising premiums, shrinking coverage, and public frustration are driven less by insurance design and more by pricing, delivery models, and political reluctance to confront trade-offs. The conversation explores healthcare costs, insurance, public health investment, innovation incentives, global healthcare systems, and lessons from countries like Switzerland, Singapore, Canada, and the UK.

What You’ll Learn

✅ Why healthcare costs in the U.S. remain structurally high

✅ How trade-offs shape healthcare policy decisions

✅ Why insurance is not the core driver of healthcare inflation

✅ The role of public health and prevention in long-term outcomes

✅ What global healthcare systems get right—and wrong

✅ Why innovation thrives in U.S. healthcare despite inefficiencies

✅ How political avoidance worsens healthcare challenges

Timestamps

• (00:00) Introduction: Academy Health and healthcare policy

• (02:54) Why healthcare costs keep rising

• (09:03) “Everything is to blame” in U.S. healthcare spending

• (18:41) The real difference between U.S. and global healthcare systems

• (29:38) Why single-payer won’t fix healthcare costs

• (31:40) Innovation, incentives, and trade-offs

• (39:45) Public vs private responsibility in healthcare delivery

• (44:44) Why insurance debates miss the real problem

Key Takeaways

💎 Healthcare trade-offs are unavoidable—there are no cost-free solutions

💎 High healthcare costs are driven by pricing and delivery, not insurance alone

💎 Public health and prevention improve outcomes, even if they don’t always cut costs

💎 Global healthcare systems balance public and private roles more explicitly

💎 Innovation in healthcare is fueled by incentives—but comes with complexity

Resource Links

Guest: Dr. Aaron E. Carroll – President & CEO, AcademyHealth Host: Roy Bejarano – Analyzing Healthcare Community: ⁠www.scale-community.com⁠ Podcast Hub: Analyzing Healthcare by SCALE Community

Guest Bio

Dr. Aaron E. Carroll is President & CEO of AcademyHealth and a nationally recognized physician, health policy researcher, and thought leader in healthcare economics. A former academic leader at Indiana University, he has spent decades advancing evidence-based healthcare policy, health services research, and public health reform. Dr. Carroll is widely known for translating complex healthcare systems, insurance dynamics, and global health trade-offs into clear, data-driven insights that inform policymakers, executives, and healthcare leaders.

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