Economics/Class Relations

Is health care too big?

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May 27, 2023



Over the last few years, health care companies in the U.S. have grown tremendously. The ascension has been brewing for a while.


In 1995, the industry was only the 13th largest on the Fortune 500. Today, eight of the top 25 companies on our benchmark list are health care companies, with UnitedHealth and CVS Health taking the lead. Combined, health care companies on the Fortune 500 generate $2.77 trillion in revenue, making the industry the second-largest on the list by revenue, just behind finance.


Much of the rapid growth has been achieved through M&A to build out an ever-growing network of doctors’ practices, urgent care clinics, pharmacy-benefit managers, and more. The goal of a company like CVS is to become a one-stop shop for all our wellness needs.


Health care CEOs say that the bigger their companies get, the better care they can provide to customers. In some ways that’s true. The more of the health pipeline they own, the more they can efficiently provide personalized solutions—which can bring down cost and increase access for more people. It also paves the way for a stronger emphasis on preventative care, not just treatments after diagnoses.


But it’s also true that no other country monetizes its sick and elderly the way the U.S. does. And the current high cost of care contributes to health and wealth inequities here—not to mention burdensome costs for other businesses. So far, big health care companies have certainly delivered growth for their shareholders, but they’re still a long way from moving the needle on cost and quality of care.


Fortune senior writers Erika Fry and Maria Aspan dig into whether what they call health care’s “radical, next-level bigness” is healthy for America, below.

Companies like CVS and UnitedHealth are now some of the world’s biggest businesses. Is that healthy for the rest of us?


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