The aim of this article is to increase understanding of the mechanisms of the continuation of elite hegemonic control of a highly valued social system—American health care. White, male physicians and administrators achieved control of the health care industry and its workers, including nurses, at the start of the 20th century. Using critical theorists’ work on authoritarianism and incorporating gender analysis, the authors describe the health care system from a critical social— psychological perspective. The authors discuss the meaning and presence of authoritarian hierarchy and gender effects in today’s health system through a critical analysis of the profession of medicine, the profession of nursing, corporate and bureaucratic health care, and patients or consumers. It is concluded that the social—psychological behavior of the American health care system has profound implications that must be taken into account in any recommendations for change.
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