The New Health Care Crisis

“We are way past the point when health care should have been overhauled in the U.S. No one should have to be worried about being bankrupted by the insurance companies or denied care. No one should have health insurance that is tied to employment. No doctor should have to put up with abuse and manipulation from the insurance companies. Health care should be available to all whenever it is needed, period. It should be broadly government supported. And all private health insurers should be not-for-profit. Medicare should have been made the national health care insurance program for everyone when it very first began, starting with birth.” – David Coster, Coz Blog (cozmd.com), “A Slave with Two Masters.”

Yes, I’m quoting myself. I wrote the above when United Health Care was finally publicly raked over the coals for ruining the lives of the patients who were paying them for health care coverage by refusing to pay for necessary medical care. The problem yet continues, unabated, in spite of public outcry, because our politicians enjoy getting bribes from health industry lobbyists.

And now, the Trump administration has made matters even worse with their plan to stop subsidizing the Affordable Care Act, an Act that was put into law with great effort and a bipartisan vote on behalf of all Americans during the Obama administration in 2010. The Republicans argue now, today, that the government is being taken advantage of by the insurance companies to whom they pay the subsidies on behalf of poor and middle-class Americans, so the program should be scrapped. I couldn’t agree more that insurance companies are taking advantage of government taxpayer money. The proposed solution? Send the money directly to the citizens instead, though there is no such legislation in process and no details of how such a plan might work for the average American. No one has mentioned the idea of reigning in the health insurance companies which had record breaking profits this past year, profits they earned by refusing to pay for necessary health care while overbilling the government for the ACA patient subsidies, both problems that could easily be solved by Federal legislation if the Republicans cared to make it happen. Republicans refuse to extend the Affordable Care Act while this gets sorted out, an obvious potential temporary solution. No one mentions the obvious solution of universal health care

Meanwhile, with the threat of this change hanging over the heads of our wonderful capitalistic health insurers, they have jacked up health insurance premiums for 2026 across the board and, in some cases, by as much as 300%. In some cases, the cost is so astronomical it will take the majority of an individuals annual income to pay the premium, not counting the out-of-pocket expenses that amount to thousands of additional dollars.

How are people doing to deal with this? I’m going to go out on a limb and say that more than half the population of the United States cannot just conjure up an additional tens of thousands of dollars per year for health insurance premiums at a moment’s notice, if at all.

This is what will happen. I can tell you how it will go. When it becomes clear to the public that no insurance company on the insurance exchange will be providing subsidized health insurance anymore and the premiums have increased to $15,000-24,000 a year or more (plus copays and deductibles), most Americans will simply go bare. No health insurance. And without health insurance, they will not even go to a walk-in urgent care clinic due to the cost, even when they are sick and should go. They will stay home until they become incredibly sick. Only then will they seek care. And when the ambulance company determines they have no health insurance, they either won’t go to pick them up, or if they do, they will charge tens of thousands of dollars for the ambulance ride. Once the patient arrives at the ER in an ambulance or the family car, by law they have to be seen, at least as of today. I imagine the Republicans will get rid of this rule as well as soon as they can. But for now, the ER cannot turn them away, so the ERs around the country will be inundated with very, very sick patients, patients who couldn’t buy insurance and so didn’t get their medications or other treatments they needed that could have kept them out of the emergency room. The ER docs will see them and admit them to the hospital because they are morally and legally required to do so. And because they are very ill, they will spend several days there being treated. And since they have no insurance, the hospital will bill them at the top rate for their care – the absolute maximum they can get away with. The patient will recover and go home, still without insurance, still without money for medications, still without the necessary medical support they need, and the whole scenario will repeat itself. Within days of their discharge, they will be getting letters from the ambulance, doctors, and hospitals indicating they owe hundreds of thousands of dollars. They will be unable to pay, so the hospital will put a lien on their property, a lien on what little they have in their bank account and then attempt to take it all. If the patient can find a bankruptcy attorney, they will file for bankruptcy, an act that will have economic consequences for years. The patient may subsequently die or become homeless. That’s how it will go all over America, so get ready for it.

In addition, of course, many hospitals required to care for all of these uninsured people will go bankrupt, as will physician offices, nursing homes, surgery centers, and so on. You can’t squeeze blood out of a turnip – people who have no money for insurance also have no money for big hospital bills, so no matter how hard the private health system works to collect the money it is owed from the poor and middle class, it will be able to retrieve only a fraction of what it lost through collections and legal maneuvers. Rural hospitals will close everywhere. Many urban hospitals will close. People will simply die due to a lack of access to any medical care. Those working in the field, such as doctors and nurses, will simply give up and walk away due to financial and moral exhaustion. We will go back to medieval medicine. Herbs and leeches. We’ll live 35 years on average if we’re lucky. This is the future of health care in America today.

And yet there is even more that can be done to make it worse: “Let’s see, we know there is a drastic shortage of physicians, nurses, physical therapists, physician assistants, nurse practitioners, and so forth already, but we think it’s in the best interest of all Americans to pretend that education for these professional careers does not count as professional education, so we are going to limit the amount that any person can borrow for student loans to get the necessary education for those careers.” You can thank Linda McMahon, Donald Trump, Mike Johnson, Robert Kennedy, and the other nitwits and criminals left in charge of the operations of the United States government for this brilliant maneuver. And you can be sure that whenever the shortage of health care professionals hits crisis level, which it is approaching, congress and the president will make sure they get the best medical care possible while Americans everywhere else die left and right.

No one in their right mind would choose to go into any sort of medical career in America in this scenario. Millions and millions of patients will overwhelm what few providers we have. They will, of course, burn out and quit, regardless of how altruistic they might be.

This is where we are, America. This is what our leaders have done to us. We had a chance a couple of decades ago, a fighting chance, to put all Americans on Medicare, a universal health insurance program that is NOT FOR PROFIT, a program that applies 98% of its revenues directly to health care and only 2% of its revenue to administrative costs. The for-profit insurers spend only 64% on direct patient care; the rest goes to administrative costs which include massive multi-million-dollar salaries for the CEO and other higher-ups, and dividends to stockholders. Because it’s not for profit, Medicare premiums cost 75% less than private for-profit insurance, and the poor pay next to nothing. But when the idea of Medicare-for-All was floated back in the 2000’s, the FOR-PROFIT insurance companies such as United, Aetna, Blue Cross, Anthem, Kaiser, and others lobbied against Medicare-for-All with all their might and stopped it dead in its tracks. The Affordable Care Act was a bipartisan (both the Republicans and the Democrats) agreement that was the compromise for not switching to Medicare-for-All. It wasn’t good enough, and everyone knew it, but it was better than what we had before and gave access to health insurance for millions of Americans, insurance they otherwise could not afford. It was as good as could be gotten with a congress that was/is in the pocket of the for-profit health insurance companies, and those of us in the medical field noticed the effect immediately. No longer did we see patients without insurance. No longer did I have to convince the hospital CEO to let me do surgery for poor patients for free. No longer did our rural hospital have to struggle constantly for adequate payments to keep it in the black. No longer did we have to run short-staffed. Literally everything got better for our patients and our hospitals after the passage of the Affordable Care Act.

I’m of the opinion that our ridiculous American experiment of health care coverage tied to employment is over. The United States is the ONLY country that does health insurance this way. The handwriting is on the wall, and no doubt the private sector knows it. This stupid experiment didn’t work. So, what are they to do to keep their investors happy and keep rolling in the dough? How about going on a rampage to rape and pillage what few people/families remain who can pay these new outrageous premiums, beginning January 1st, 2026? Of course! They have to line the pockets of their CEO’s, stockholders, and upper management with as much money as they can before government money gets shut off because regular Americans are PISSED OFF. This for-profit insurance company gravy train needs to go off the rails. Every other civilized nation has access to tax-based health care with minimal or no cost associated with visits to clinics and hospitals. The action by Republicans in passing the Big Beautiful Bill, ending the only insurance program that was helping the poor and middle class – the Affordable Care Act – may, ironically, prove to be the end of the current health care system in the United States and likely force the changeover to universal health care. I imagine this is not what the Republicans anticipated considering their rabid support of pure capitalism, but there it is. They will have inadvertently done some good if that happens. The problem is they laid no safety net for the millions who will lose their insurance in the meantime.

There is a simple solution, and pure capitalists won’t like it in concept but will in practice, because people in every other civilized democratic society, all of which have combined socialist/capitalist democracies – do. The government – if it’s ever stable again – should take control of the health care system and roll all private health insurance companies into Medicare and switch the entire system over to Medicare rules. No more public investors, no more massive salaries, no more wars between health insurance companies for market share, just one electronic medical record instead of dozens that can’t talk to each other, no more battles between doctors and insurance companies, no more pre-authorizations, no more BULLSHIT.

“You socialist!” some might scream at me for even suggesting such a thing. And to that, I have to ask: Who’s in charge here, the three hundred and fifty million people in this country, or a couple dozen CEO’s who are raping the American public to the tune of trillions of dollars every year and leaving millions of Americans in the poorhouse and/or without health care? NO OTHER “FIRST WORLD” COUNTRY HAS ALLOWED THIS TO HAPPEN TO THEIR PEOPLE! Over seventy countries have universal health care that doesn’t break the bank for their citizens!

But what about the upper middle class and wealthy investors?! They’ll lose their mutual fund and stock profits from their health insurance company and for-profit hospital investments! Yes, they will. But they’ll get guaranteed tax-supported health care at no additional cost and if they value it as much as they do the value of their health insurance company stocks it will be worth the trade. Consider it an investment in a better society and shut up.

If you really want to make America into something great, it’s going to require the full application of the concept of a socialist-capitalistic democracy, a place where socialism applies to the aspects of life and the economy which require all of us to cooperate and help each other, such as health care, transportation, safety standards, food supplies, energy, scientific research, education, and housing; where capitalism applies to entrepreneurship and types of businesses that do not affect the survival and safety of the people; and where democracy applies to the right of the citizens, not the politicians, to dictate how it will all go.