The U.S. health care system, which makes up almost 20 percent of the economy and continues to grow, is complicated and full of contradictions. Columbia University sociology professor Adam D. Reich has written an excellent book that describes these contradictions, specifically focusing on the tension between market forces and altruism in the delivery of health care.

In agreement with hospital historian Rose Mary Stevens that hospital organizations continue to “carry the burden of unresolved and perhaps unresolvable contradictions of the healthcare industry” (p. 1), Reich’s study focuses on hospital care in the United States. In discussing the role of market forces in U.S. hospital care, Reich employs the notion of commodification, defined as the process of turning hospital care into something bought and sold on the market. Believing that health care is too important to be viewed as a typical commodity, and in agreement with economic anthropologist Karl Polanyi and philosophers Debra Satz and Michael Sandel, Reich finds three problems with commodification: it is unjust and coercive, it undermines and debases the very value of health care as a service, and it can cause malcoordination and anarchy as a result of uncertainty.

To demonstrate the contradictions and tensions inherent in hospital care, Reich studied three separate hospi