The US built health care around profit first, people second, and now the bill arrives every month as a premium.
Several things stack together:
Insurance companies do not just spread risk. They sell a financial product and chase margin. Executives receive bonuses for higher returns, not for healthier populations. That incentive pushes constant premium growth, creative cost shifting, and narrow networks.
Hospitals act like regional monopolies. Large systems buy smaller clinics, then raise prices once they control the local market. Insurers then accept higher prices, pass the cost into premiums, and call it “negotiation.” Patients and employers pay for the truce.
Drug and device firms treat sickness as a high-yield asset. Patent rules, weak price controls, direct-to-consumer marketing, and heavy lobbying all protect high launch prices and slow price drops. Every expensive new drug flows straight into higher premiums and higher taxes.
Employers sit in the middle and treat health insurance as a wage-suppression tool. Instead of higher pay, workers get fatter premiums with higher deductibles. Household budgets feel squeezed from above (premiums) and below (out-of-pocket costs).
Politicians receive large donations from all those sectors. That money protects the structure and blocks reforms that would cap prices or shrink profit margins. Other rich countries treat health care as infrastructure. The US treats it as an industry lobby with a flag on it.
So you end up with a “market” where sick people do not have real choices, healthy people feel trapped by employer plans, and investors treat human illness like a growth sector. Greed plays a role, yes. Design plays an even larger one. A society sets the rules, then the players follow the money through every gap.
