Why people should matter over profit

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.

82% of non-profit hospital systems spent less on charity care and community investment than the value of their estimated tax exemptions

$18.4 billion in tax savings that should have supported the communities they serve

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 PrioritizedPeople 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.
Follow the money with us

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.

Together, we can turn their profits into investments for our communities

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.

“Even when they’re playing the game legally, we are lining the pockets of very wealthy corporations that are not improving patient care.”
Dr. Donald M. Berwick, former administrator of the Centers for Medicare and Medicaid Services, Obama Administration

Our Approach

  • Expose where the money goes, where it doesn’t go, and its impact on communities
  • Build and share knowledge as a health advocacy and justice community so we all have more clarity about how the health system operates from a financial standpoint — and how to disrupt it
  • Launch public awareness and engagement campaigns that bring to life how the health system’s profit-driven approach hurts people
  • Build coalition power along with community-based organizations and advocates to design roadmaps for change and implement strategies that shift investment to people and communities — especially those hurt most by our system today
An older woman with deep red hair is wearing a lightweight green parka while standing in a park, with trees in green and yellow blurred in the background.

$1 trillion invested by private equity into nearly 8,000 health care transactions during the past decade

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.

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