We spend more than $4.5 trillion on health care. Yet, 100 million Americans suffer from problems such as: … (+)
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The online outrage against the health care industry over the past two weeks exposes the deep levels of hopelessness, helplessness, and anger experienced by millions of Americans who feel betrayed by the health care system. I did.
If you visit the “About Us” page on any major health insurance provider's website, you'll see Aetna's commitment to helping individuals “live healthier lives” and United's commitment to “making the health system work better.” You'll see lofty mission statements, such as healthcare goals. everyone. “Meanwhile, a press release for UnitedHealthcare's investor conference stated that operating cash flow in 2025 is projected to be between $32 billion and $33 billion.
This cognitive dissonance isn't all the insurance company's fault. Rather, it reflects how the U.S. health care system is designed. Unlike other countries, we rely on a market-based approach to healthcare, where insurance companies and hospitals are expected to act as economic actors. It is a system that is long overdue for reform.
Before the existence of health insurance companies in the early 20th century, Americans paid for health care out of their personal savings or through charities and mutual aid associations. Health insurance was created in the 1930s and 1940s to protect individuals from unexpected financial risks and improve access to necessary medical services. Since its inception, health insurance in the United States has been primarily employer-based (meaning provided by employers as a benefit to their employees) and provided through private companies such as UnitedHealth, Aetna, and Cigna. While government-sponsored programs such as Medicare, Medicaid, and the Affordable Care Act Marketplace serve certain eligible people based on age and income, employer-sponsored health insurance remains a domestic It is the greatest source of security.
So what is the current situation? Currently, 1,176 private health insurance companies offer a staggering number of plans in the United States. In 2022 alone, the six largest health insurance companies made a combined profit of $41 billion, according to Becker's Healthcare. Despite documented reports of false advertising, deceptive marketing, and deceptive sales practices, there are so many companies that effective regulation is difficult and expensive. Masu. Private insurance plans have average administrative costs of 12.4%, compared to just 2.2% for traditional Medicare.
According to the Kaiser Family Foundation, the United States spends more than $4.5 trillion on health care. But we pay too much for health care, and even though 92% of the population has health insurance, 41% of American adults still struggle with medical debt.
This problem goes beyond health insurance. We need a fundamental restructuring of our health care system to reduce waste and increase value. Experts estimate that creating a single-payer health care system could save approximately $450 billion to $503 billion annually. For example, in the UK, where most hospitals and healthcare providers are publicly funded, single payer does not necessarily have to take the form of a national health insurance. Countries such as Canada and Spain have adopted locally managed and funded single-payer systems, increasing the private provision of health services and increasing the role of private insurance. And certainly there are other options that could be better adapted to the U.S. situation, such as Germany's multipayer system that pools risk to provide universal health coverage. Perhaps the most promising path for the United States is the public option, which I discussed in a previous article. This approach would allow people to enroll in government-run plans that could potentially compete with private insurance companies, perhaps at the state level.
As an emergency physician who has lived and worked in many countries where health care is universally funded, it is clear that Americans overall receive poor care and face significant barriers to care. Yet, according to the Kaiser Family Foundation, we pay far more medical debt. The amount is as much as $88 billion. This is more than just a burden for a segment of the population. 100 million Americans (nearly 1 in 3) struggle with medical debt. This level of economic hardship is completely unprecedented in other developed countries.
We cannot continue down this path. Reforming the way we finance and deliver care, whether it's a public option, a multi-payer system, a single-payer system, or something entirely new, is causing a lot of despair across this country. It is the only true way to fundamentally address dysfunction.
