U.S Healthcare Cost

Follow the Money

The high cost of healthcare in the U.S. is a complex issue, driven by the profit motives of several key players who benefit from the system, while many Americans suffer from unaffordable care and inadequate outcomes.

1. For-Profit Insurance Companies

Insurance companies like UnitedHealth Group and Anthem post billions in profits annually while premiums and deductibles rise for consumers. In 2024, UnitedHealth, for example, reported $371 billion in revenue, making it the largest healthcare company by revenue in the U.S. These companies profit by charging high premiums while limiting access to care by implementing complicated reimbursement systems. Even with government subsidies, many Americans still face substantial out-of-pocket expenses, further burdening middle- and lower-income individuals.

2. Pharmaceutical Giants

Pharmaceutical companies such as Pfizer, Merck, and Johnson & Johnson benefit enormously from the U.S.'s lack of price regulation. Americans spend nearly $1,500 per capita on prescription drugs, about twice as much as citizens in other developed countries. These companies can charge exorbitant prices for life-saving medications due to weak government intervention, often receiving billions in subsidies for research and development while driving up costs for consumers.

3. For-Profit Hospital Systems

Major hospital systems like HCA Healthcare and Tenet Healthcare rake in massive profits, even as hospital charges for common procedures far exceed those in other developed countries. For instance, HCA Healthcare posted over $60 billion in revenue in 2022, despite rising complaints of overcharging and billing irregularities. These systems prioritize profitability, leading to inflated costs for basic healthcare services like hospital stays and surgeries, often leaving uninsured or underinsured patients with unmanageable debt.

4. Pharmacy Benefit Managers (PBMs)

PBMs act as intermediaries between insurers and drug manufacturers, negotiating drug prices and deciding which medications are covered. The three largest PBMs—CVS Caremark, OptumRx, and Express Scripts—control nearly 90% of the prescription drug market. These companies prioritize profit, often through hidden fees and rebates, driving up the cost of medications. PBMs have been found to mark up prices for life-saving drugs, profiting at the expense of both patients and smaller pharmacies​

5. Healthcare Consultants

The healthcare consulting industry is projected to grow to $41.2 billion by 2026, benefiting from increased demand for more efficient healthcare models. Consultants like Accenture, Cognizant, and the Big Four accounting firms help healthcare providers and insurers optimize their operations—often to maximize profits, not patient outcomes. These firms profit from the complexity of the healthcare system, contributing to high administrative costs that are passed down to consumers​.

These dynamics illustrate a Lower Consciousness (LC) mentality, where profit maximization takes precedence over compassion, justice, and the collective well-being of society. The OM framework would view this as a system that prioritizes egoic, material-driven goals at the expense of holistic well-being. Instead of cultivating a healthcare system that serves all equally, the current structure favors those with the most financial and political influence.

Government Subsidies Enable Profits While Burdening Citizens

Despite spending over $1.5 trillion on Medicare and Medicaid annually, these systems still leave significant gaps in coverage, and private insurance continues to dominate. Government subsidies, while meant to aid Americans, often end up bolstering the profits of pharmaceutical and insurance companies. In the 2022 election cycle alone, healthcare companies spent over $700 million on lobbying, ensuring policies that protect their interests while maintaining high consumer costs.

U.S Citizens Sentiment

The average U.S. citizen feels frustrated, betrayed, and powerless when confronting the reality that while they struggle to afford basic necessities, including healthcare, large corporations within the healthcare industry continue to reap enormous profits. This disparity becomes even more stark when considering how pharmaceutical companies, insurance firms, and pharmacy benefit managers (PBMs) continue to drive up costs while essential medical services become increasingly inaccessible.

1. Frustration with Rising Costs: Despite paying some of the highest healthcare costs in the world, Americans often face subpar outcomes and medical debt, with many unable to afford basic treatments. The fact that companies like UnitedHealth Group, which reported $371 billion in revenue, and Pfizer, which consistently earns billions in profit, are profiting so heavily only adds to the disillusionment of ordinary citizens​

   
   

2. Betrayal by the System: Many Americans feel betrayed by a system that seems to prioritize corporate profits over public well-being. PBMs, insurance companies, and hospital systems are known for their complex pricing schemes and lack of transparency, leaving patients with overwhelming bills for essential services. This drives the perception that the system is rigged against them.

   
   

3. Powerlessness: For those struggling with healthcare costs, there is a sense of powerlessness due to the lobbying power and political influence of these major corporations. With over $700 million spent on lobbying in healthcare during the 2022 election cycle, it's clear that healthcare companies hold considerable sway over policy decisions, often shaping laws to benefit their profits rather than the public interest​

Conclusion: A Shift Toward Higher Consciousness (HC)To resolve these issues, OM advocates for a shift away from this LC mentality toward one that prioritizes Higher Consciousness (HC)—a system where healthcare is treated as a human right, not a commodity. This would involve price transparency, government regulation of drug prices, and an emphasis on preventive care and patient outcomes, instead of profit maximization. By doing so, the system could evolve to one based on compassion, justice, and equitable access to care, ensuring that health and well-being take precedence over corporate greed.