The U.S. Healthcare Hustle: Top Dollar, Bottom Rankings. Flipping the Script on U.S. Health
The United States spends more on healthcare than any other country on earth—yet we are consistently outperformed by our global peers in nearly every major health metric. It's a paradox that has left many Americans wondering: How can we spend so much, and still be so unhealthy?
In 2023, U.S. healthcare spending soared to $4.9 trillion. This breaks down to about $14,570 per person. That’s nearly double the average spending of other high-income countries like Germany, Japan, and the UK. They’re only spending around $6,500 per person (Health System Tracker). Despite these extreme costs, Americans have lower life expectancy, higher infant and maternal mortality rates, and more chronic illness. So where is all that money going? And more importantly, how do we get back on track?
Is America’s Healthcare System Broken?
Despite the staggering amount spent, the U.S. healthcare system is constantly leaving people sicker and overlooked. The system is broken. Where you live, your income, your race, and even your ZIP code can dramatically affect your access to care and health outcomes.
Racial and Ethnic Disparities: Black women are 3 to 4 times more likely to die from pregnancy-related causes than white women. Hispanic and Native American populations face higher rates of diabetes and heart disease, often due to limited access to care and nutritious food.
Income Disparity: Low-income individuals are less likely to have health insurance, more likely to delay or skip care, and often live in environments that contribute to poor health—like food deserts or polluted neighborhoods.
Rural vs. Urban: People in rural areas face higher mortality rates from preventable diseases due to fewer hospitals, specialists, and public health resources.
Health isn’t just about biology—it’s about systemic opportunity. Until we address social determinants like housing, education, transportation, and racial bias in healthcare, we can’t expect health equity.
The United States is spending thousands every year on healthcare for individuals. So now you have to wonder - Where is the money going if there are still millions of people without coverage?
Where the Money Goes:
If not directly to the people, where does the money go? Let’s dive in.
Administrative Overhead: In 2020, we spent $1,055 per person just on administrative costs—five times more than the OECD average of $193 (Commonwealth Fund).
High Drug Prices: Americans pay more for prescription drugs than anyone else in the world. For example, insulin that costs $6 in Australia can cost up to $300 per vial in the U.S.
Fragmented Care: Most Americans are covered through a patchwork of private insurers, government programs (like Medicare or Medicaid), while many remain uninsured altogether. This creates gaps in care, delays, and confusion—often leading to worse outcomes.
America’s healthcare system is broken in many ways. It didn’t get like this overnight and it won’t be fixed overnight. The values at the heart of the system need to change. So let’s consider what that could look like.
Inspiring a Shift in the System
At the heart of the problem lies a flawed model: our system is built around “sick care” rather than health care. We value treating illness after it occurs rather than preventing it in the first place. To inspire a shift in this system, these values need to change.
The Value of Root-Cause Medicine: Instead of masking symptoms with prescriptions, a root-cause approach aims to identify and fix the underlying contributors—whether it’s poor diet, chronic stress, sleep deprivation, or environmental toxins.
The Value of Outcomes Over Volume: We must move from a fee-for-service model (getting paid for the number of tests or visits) to value-based care (getting paid for better patient outcomes). This aligns incentives with patient health—not procedure volume.
The Value of Prevention: Only a small fraction—less than 3%—of U.S. healthcare dollars go toward prevention. Reversing this trend means investing in nutrition counseling, screenings, exercise programs, and behavioral health—tools proven to reduce chronic disease burden. Imagine if healthcare were like car maintenance. Would you rather spend $50 on an oil change, or wait until the engine seizes and pay $5,000 for a new one?
What Can You Do? (Yes, You!)
Prioritize Your Health: Show the world the value of honoring your health. Stay up to date on screenings, move your body daily, sleep well, manage stress, and eat whole foods. Prevention starts with you.
Support Local Health Programs: Volunteer or donate to community health centers, food banks, or mobile clinics. These initiatives make a real impact.
Choose Value-Based Providers: If possible, seek out care teams that focus on long-term wellness—not quick fixes. Start saying no to inadequate or unethical care by saying yes to those who are doing it right.
Talk About Health: Normalize conversations about mental health, chronic illness, and caregiving. We’re stronger together.
Stay Informed + Be An Advocate: Healthcare is personal—but also political. Understanding how systems work helps you advocate for smarter policy. Call your representatives and demand action on drug pricing, health equity, and preventive care funding.
The Last Bite
You’re a part of this system either passively or actively. Change happens when individuals come together to make a big impact. This isn’t just a national issue. It’s a personal one. We all know someone impacted by medical debt, delayed diagnoses, or poor access to care. The fix will require courage, cooperation, and compassion. But it starts with each of us. This is a heavy topic - but the good news is that you have a chance to make a difference. So let’s keep the conversation going.
How has your healthcare experience shaped your view of the system? What changes would you like to see?