Profits Over Patients: America’s Healthcare System

Shania Sarango

$60,548.30. That’s how much my mother’s hospital bill was when she had an emergency surgery in April of 2024. She makes much less than that in one year. How is she expected to pay this amount of money? How is anyone expected to for that matter? Luckily, my mother has health insurance. It’s the most basic plan and it’s pretty decent, but we haven’t heard back from them regarding coverage. It’s been 5 months and so far she’s gotten her X-rays and CT scans covered, but she was in the hospital for 6 days. That’s 6 days worth of pain medication, antibiotics, IV fluids, meals, and round-the-clock care. 

I’m not trying to bash our health insurance. I have no doubt in my mind that the majority of my mother’s hospital bill will be covered. We’re a low-income family living in Newark, NJ with Medicaid. What annoys me is the fact that a hospital bill can be that high in the first place, forcing my mother to deal with out-of-pocket costs. 

Across the United States, many people find themselves in medical emergencies that can lead to crippling debt. According to the article “How financially vulnerable are people with medical debt?” by Aubrey Winger from the Kaiser Family Foundation, nearly 1 in 4 or 23% of Americans have significant medical debt. Even with health insurance, out-of-pocket costs can be significantly high for some families. Why are healthcare costs in the U.S. so high?

Unlike other developed nations, the U.S. doesn’t have a single-payer system where healthcare is universally available. We have a system where hospitals, insurance companies, and even pharmaceutical manufacturers operate for profit, resulting in increased costs for healthcare services. That’s why an X-ray in the U.S. can be much more expensive compared to a country like Canada, with universal coverage.

Because the U.S. doesn’t offer universal coverage, we’re stuck with public or private insurance. If you’re from a low-income family, you get Medicaid. If you’re elderly and retired, you get Medicare. With private insurance, you’re required to pay premiums every month. Even if you don’t receive any healthcare services for one month, you’re still required to pay the premium for that month. Isn't it ridiculous? 

Hospitals also play a pretty big part in driving up healthcare costs. They have the freedom to determine their own list prices for their services, especially medication. According to Nicole Longo in “New report: Hospitals mark up medicine prices 500%”, hospitals typically charge 200-700% more than what they pay for certain medications. Additionally, in the article “Most top hospitals charge a more than 5x markup” by Tina Reed, 57 of the top 100 hospitals in the U.S. charge more than 5 times the actual cost of the care they provide. That means a procedure that costs these hospitals $1,000 to perform might be billed to a patient for $5,000. This can’t possibly be fair to us. 

The profit-driven U.S. healthcare system doesn’t just affect emergencies like my mom’s surgery, it also plays a big role in cancer care. In his article “The Cancer Industry: Hype Versus Reality”, John Horgan highlights how hospitals and pharmaceutical companies prioritize profits through overdiagnosis and overtreatment, with minimal benefit to patients. This mirrors the increased costs I mentioned before, where hospitals mark up medications and services way more than they should. Whether it's medical emergencies, routine medical care, or cancer treatment, patients are left to deal with the financial burden of a system designed to maximize profits, not their health and wellness.

So, what are the potential solutions to this problem? Perhaps a huge shift toward a single-payer healthcare system, where our government could cover the cost of healthcare for everyone. We’re the only wealthy, industrialized country without universal healthcare. Expanding Medicaid or Medicare across the country would eliminate profit motives for insurance providers, hospitals, and pharmaceutical companies. Unfortunately, our political system limits major social policy changes. So, maybe we could regulate the costs of medication and healthcare services. This would make healthcare more affordable for millions of people without completely changing the system we already have. 

The issue of healthcare costs in the U.S. is too complex and trying to fix it would require us to consider many factors. But one thing is clear: the current system leaves many Americans vulnerable to financial debt after a medical emergency. Families like mine shouldn’t have to wait in fear of a bill, wondering if they’ll be able to afford the care they rightfully deserve. We need a healthcare system that puts people before profits, and until that happens, stories like my mother’s will continue to be all too common.

References:

https://www.kff.org/health-costs/issue-brief/how-financially-vulnerable-are-people-with-medical-debt/#:~:text=This%20analysis%20of%20government%20data,or%20relying%20on%20costly%20loans.

https://phrma.org/Blog/New-report-shows-hospitals-mark-up-medicine-prices-500-percent

https://www.axios.com/2021/06/14/texas-pennsylvania-hospitals-top-average-markups

https://johnhorgan.org/cross-check/the-cancer-industry-hype-versus-reality