Investing in community leaders is essential
Applications to the 2024 Restuccia Health Justice Fellowship are now open!
The U.S. health system does many amazing things, and there are many dedicated, compassionate people who provide excellent care. At the same time, the financial underpinnings of the system prevent most people from gaining and maintaining their optimal health.
Health care in the U.S. is horribly expensive, severely inefficient, and people don’t get the care they deserve — all because profits are the priority. Too often, profit trumps community needs, and a tremendous amount of money is funneled to wealthy executives and shareholders at the expense of people and communities.
It’s no wonder that the majority of people in the U.S. are unhappy with the health system. The U.S. has some of the most expensive health care in the world with mediocre and grossly unequal health outcomes to show for it. As a result of discrimination, systemically excluded communities — including Black and brown people, Indigenous people, women, LGBTQ+ people, older people, and people with disabilities — are disproportionately harmed.
The effects are both individual (in how people are treated and the impact that has on their health) and structural (in how the system is actually set up and managed). Its impact ripples across entire communities and our country.
Take, for example, non-profit hospitals. They make up nearly half of all hospitals in the United States and receive billions of dollars in annual tax breaks.
In exchange for a non-profit status, hospitals are required by law to invest in charity care and community health initiatives. Yet, a 2022 study conducted by the Lown Institute found that 82 percent of non-profit hospital systems spent less on charity care and community investment than the value of their estimated tax exemptions. In other words, they raked in $18.4 billion in tax savings that should have supported the communities they serve.
These non-profit hospitals generally behave more like profit-maximizing entities than community-focused care providers.
This isn’t an unfortunate outlier — just one in a series of offenses by the health industry, including insurance companies, hospitals, and prescription drug companies.
To name a few more:
|Profit is Prioritized
|People are Hurt
|A review of dozens of fraud lawsuits, inspector general audits, and investigations by watchdogs shows how major health insurers exploited Medicare to inflate their profits — by billions of dollars.
|“One in five Medicare beneficiaries said that they spend half or more than half of their monthly incomes on healthcare expenses. Those healthcare expenses include premiums, prescription drugs, and other costs not covered through fee-for-service Medicare. However, for over a quarter of Medicare recipients, Medicare premiums were their highest healthcare costs.”
|The health care industry has become increasingly consolidated and powerful. This lack of competition allows the industry to drive up premiums, making care even more expensive for people with insurance.
|One-third of insured adults worry about affording their monthly health insurance premium, and 44 percent worry about affording their deductible before health insurance kicks in.
|For the past two decades, the pharmaceutical and health products industry has spent more than $5 billion in lobbying efforts alone — by far the most of any industry.
|About three in 10 (29 percent) of all adults report not taking their medicines as prescribed at some point in the past year because of the cost. This includes about one in five who say they didn’t fill a prescription (19 percent) or took an over-the counter drug instead (18 percent), and about one in 10 (12 percent) who say they cut pills in half or skipped a dose. Three in 10 of those who report not taking their medicines say their condition got worse as a result.
|Private equity, which is designed to generate profit, has dramatically increased its reach into the U.S. health system — buying up physician practices, hospital systems, nursing homes, and dental practices.
|When private equity buys a health care company, patients often pay the price. A 2021 study concluded that private equity ownership increases the short-term mortality of nursing home residents by 10 percent: that’s more than 20,000 deaths over a 12-year period. This is most likely due to rerouting patient care funding to private equity owners.
Together, we can expose the corporate interests that drive decisions in our health system, and all the ways prioritizing profit over people’s health hurts our communities and country. By following the money trail together, we can better understand — and challenge — the business of the health system today.
Our focused efforts will pressure the health system to shift its enormous financial gains toward more people-first priorities, shaped by community members — not shareholders.
A health system that prioritizes people? Now that makes sense.
Structural challenges behind the high costs in health care include the role of private equity firms and venture capitalists. These groups frequently purchase hospitals or entire health care systems and use business strategies designed to maximize profits. This increases value to shareholders, rather than health care providers and patients.