This paper uses elements of the macrotheory of advanced capitalist societies developed by Jurgen Habermas and other “critical theorists” to locate and explore the implications of the continuing corporatization of the U.S. health care sector. It questions the often-dominant view that cost is the major problem of current U.S. arrangements, and shows how most recent government policies have reinforced the corporate rationalization of health care, or at least proved neutral towards it. Yet it can be argued that it is precisely this “rationalization” which renders more difficult both cost-control and the much-needed broadening of the agenda of the health care debate to important issues other than cost.

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