American Healthcare: A Warning from Inside the System

I made a mistake on Saturday morning when I logged into my healthcare insurance portal to check my new premium for January.

I expected my rate to rise somewhat due to healthcare inflation, but I was entirely unprepared for what I discovered: my monthly insurance premium would jump from $591 to $961, a staggering 63 percent increase. In any honest accounting, that’s thievery. What infuriates me most is that U.S. political elites always manage to find resources to bomb others around the world, yet they have never delivered universal healthcare where everybody is in and nobody is out. Instead, the healthcare robber barons who purchase our Congress every election cycle ensure that ordinary Americans must ration healthcare, skipping doctor’s visits and postponing preventive care until medical situations often become critical.

The Hidden Costs of American Insurance

Monthly insurance premiums are only part of what Americans pay for healthcare. A visit to my primary care physician (which often means seeing his assistant rather than the physician himself) costs $40. A specialist visit runs $80. The cost of the actual treatment or exam isn’t included; that’s just the co-pay that gets your foot in the door. My insurance doesn’t begin covering healthcare expenses until I have spent $5,900 annually, a threshold known as the deductible. While lower deductibles seem attractive, they simply mean higher monthly premiums. Yet even after paying my deductible, I remain responsible for 40 percent of all healthcare charges that providers bill to the insurance company, a burden known as coinsurance.

Americans pay a larger share of their national income on healthcare than residents of any other developed nation. The current system is fragmented: government programs like Medicare and Medicaid serve specific demographic groups, employer-based insurance covers workers, and the Affordable Care Act created marketplaces where individuals can purchase coverage—with subsidies for those who qualify. However, employer-based insurance, while still the most common coverage source for nonelderly Americans, has declined steadily over the past two decades, both in terms of employers offering plans and the percentage of individuals covered.

The Illusion of Affordability

As a self-employed consultant, I purchase my healthcare through the Affordable Care Act marketplace. Despite its name, there is nothing affordable about it. During the pandemic, Democrats temporarily enhanced subsidies, allowing more people to maintain affordable coverage, but they built in a sunset provision. Those subsidies are now expiring, with Republicans in Congress unwilling to extend them.

Why are my rates skyrocketing when I have never qualified for any subsidies? The answer reveals the fundamental problem: in the United States, healthcare is not a right. It is a commodity within a system deliberately financialized to maximize shareholder dividends. By design, this system is saturated with fraud, lack of transparency, complexity, and waste.

Insurance companies are preemptively raising monthly premiums for all customers, including those who never received subsidies, because they anticipate that subsidy expirations will prompt generally healthy people to abandon insurance entirely when they see their new rates. The companies understand that their remaining pool of insured individuals will be sicker and more expensive to cover. But we would be naive to think that the insurance sector, in their new pricing policy, is only accounting for its expected increased costs, and that it is not also taking this opportunity to “improve” their profit margin. Their objective is cynical and clear: collect as much revenue as possible while denying as many claims as they can justify.

Healthcare Insurance as a Fundamentally Flawed System

When examined carefully, healthcare insurance is a massive scam. Healthcare should be understood as a service that every person will need from birth until death—not as a contingency we hope never occurs. Even in that context, solidarity should never be commodified. Healthcare insurance provides absolutely no value; it merely redistributes funds while siphoning a substantial portion to investors. What we need, in the United States and everywhere, is a single-payer system where everyone contributes according to their means and receives care according to their needs, with no additional out-of-pocket expenses.

But insurance is only part of the problem. Unregulated drug pricing represents another systemic rot. When I recently contracted COVID-19 for the first time in late August, my physician’s assistant prescribed Paxlovid, a medication proven to reduce hospitalization risk, shorten illness duration, and protect vulnerable populations from severe disease. He also delivered unexpected news: commercial insurance does not cover Paxlovid, and I should go to find a manufacturer discount card on their website.

When I called my pharmacy, they confirmed the reality: my soon-to-be $1,000-per-month insurance would not pay for this treatment. My out-of-pocket cost would be $1,400. After struggling to locate the correct discount card, my pharmacist informed me my copay would be $10. You need not be a healthcare policy expert to recognize the absurdity: the same medication costs either $1,400 or $10 depending on whether you navigate the pharmaceutical company’s website successfully.

A System in Crisis with Lessons for the Rest of the World

The failures extend far beyond insurance and drug pricing. Even privileged populations in the United States have health outcomes that fall below the average for comparable developed nations. While medical bankruptcies are virtually nonexistent in Europe, two-thirds of all bankruptcies in the United States involve medical bills.

I am sharing my experience because I see a deeply troubling erosion of universal healthcare in Slovakia. Market deregulation is advancing commodification and financialization across the Slovak healthcare sector. In the United States, healthcare has become a commodity increasingly out of reach for ordinary people. The system actively incentivizes individuals to forgo or delay necessary care. Let my story serve as a warning for Slovakia and all nations tempted to follow the American path.

The author is the founder of the Catch Fire Movement, a political consultant, and a former member of the Flagstaff City Council.