Investors are in control of U.S. health care

The control of U.S. health care by investors and corporations has far-reaching implications for both costs and health outcomes. As the landscape of health care evolves, substantial evidence points to financial incentives driving a system that increasingly prioritizes profit over patient care.

### The Growing Burden of Health Care Costs

Health care costs in the U.S. are not just high; they are surging at an alarming rate. The Affordable Care Act (ACA) Marketplace premiums are set to rise by 18% next year, a significant increase, particularly for those who may lose enhanced federal subsidies due to congressional inaction. Employers, too, are bracing for increases in their health insurance premiums, which are forecasted to reach $25,000 for family coverage by 2026.

Currently, the average American pays more than $17,000 annually for health care, encompassing insurance premiums, copayments, and taxes that fund public programs like Medicare and Medicaid. This figure starkly contrasts with the spending levels in other affluent nations, where the U.S. spends approximately 50% more than countries like Canada and Australia—all while failing to achieve better overall health outcomes.

### Inequitable Health Outcomes

Despite these exorbitant expenditures, U.S. health care does not yield commensurate benefits. Americans are, on average, living 4.1 years shorter than their counterparts in other wealthy nations, receiving less hospital care, fewer doctor visits, and a reduced number of prescription drugs. Alarmingly, 27 million Americans remain uninsured, a statistic projected to worsen post-implementation of new health care cuts.

The commonly cited reasons for our unsustainable health spending often include an aging population, rising chronic disease rates, and the costs of innovative medical technologies. However, other nations facing similar challenges manage to maintain lower health expenditures while providing universal coverage.

### The Shift to Private Insurers

Since the 1980s, there has been a systematic shift in U.S. health care, particularly with government programs like Medicare and Medicaid increasingly relying on private managed care insurers. Initially touted as cost-effective solutions, this shift has resulted in substantial overpayments to these private insurers, totaling an estimated $615 billion. Insurance companies manipulate the risk-adjustment systems to maximize their profits, often at the taxpayers’ expense.

Moreover, the consolidation of hospitals and health services has led to quasi-monopolistic environments. Major players like UnitedHealth have diversified into conglomerates that include not just insurance but also pharmacies, home care agencies, and more. This vertical integration creates perverse incentives—care decisions may prioritize corporate profit over patient health.

### The Functionality of Profit-Driven Care

The profit motif entrenched in U.S. health care inefficiencies translates funding away from essential care. Data shows that corporate entities diverted at least $2.6 trillion from patient care to shareholder payouts between 2001 and 2022. In practical terms, this has fostered an environment rife with bureaucracy. The overhead costs incurred by private insurers are significantly higher than those of government programs, often consuming nearly one-third of total health spending, a stark contrast to countries like Canada where administrative costs are much lower.

This profit orientation further distorts clinical care. Comprehensive primary care has been relegated to a low priority because it is less lucrative than high-cost services like surgeries or specialized treatments. The intense focus on profitability results in longer wait times for primary care appointments and contributes to long-term health implications for Americans.

### The Path Forward

Tackling the health care crisis requires a shift away from profit-driven models towards a system that prioritizes patient welfare. Advocates propose decommercialized national health insurance—a single-payer system financed through progressive taxes that eliminates deductibles and copayments. Such a reform would drastically reduce administrative waste, redirect funds to primary care and public health initiatives, and fundamentally reorient the U.S. health care system towards delivering health gains over shareholder profits.

By adopting this model, we could free communities from corporate interests that have come to dictate so much of our health care landscape. It signifies a collective shift towards empowering patients and communities rather than investors.

### Conclusion

The current reality of U.S. health care serves as a stark reminder of the consequences of allowing profit motives to dominate health priorities. As costs continue to rise and outcomes remain dismal, it is crucial for both policymakers and the public to recognize the need for systemic change. A national health insurance model could lay the groundwork for a more equitable, efficient, and health-focused system. In doing so, we could reclaim health care as a fundamental right for all Americans, ensuring that the focus shifts from making profits to promoting health and well-being.

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