tfreeman
Jun 11, 2025
Writing Feedback / Argumentative paper: The Price for Life: A Profit-Driven Healthcare [3]
Kia Freeman
Joan Snyder
English 102: Section: 10
Title: The Price for Life: A Profit-Driven Healthcare Crisis
The United States, one of the wealthiest countries in the world, spends more money on healthcare per person than any other country, yet still has the worst life expectancy, maternal death, and infant mortality rates of any other developed nation. The American healthcare system has become heavily privatized and unapologetically capitalistic. What began as a practical and resourceful way to combat wage inflation after World War II, has snowballed into a complex and unforeseen set of consequences that are now difficult to change. Today, the number one priority of pharmaceutical companies, hospitals, and insurance companies is to generate profit to keep shareholders wealthy and satisfied. Profitability and medicine are inherently incompatible. Medicine relies on altruism and integrity, while corporations often prioritize their survival at all costs, even to their own detriment, and the people who rely on it; much like a malignant tumor. Profit-driven healthcare in the United States leads to worse patient health outcomes by prioritizing financial gain over safe and effective care, resulting in increased morbidity and mortality.
"We know the health system does not work as well as it should, and we understand people's frustrations with it, no one would design a system like the one we have. And no one did. It's a patchwork built over decades."- Andrew Witty.
Most countries formed their healthcare systems deliberately. The United States, on the other hand, developed its system through a host of reactionary laws, policies and political compromises. This unintended consequence of history gave way to profit-driven healthcare and its detrimental effects. Understanding the historical context of how the American healthcare insurance industry developed is imperative in identifying the root cause of the problem and ultimately changing it. In the NPR podcast, All Things Considered, a Princeton professor and healthcare policy expert recalls the historical stumbles that led the American healthcare system down its current path. Healthcare in America had humble beginnings. Before the early 1900s, medicine was a simple, archaic, but affordable fee for service, between doctor and patient. Health insurance existed at the time, but was very uncommon. Hospitals were seen as a place where the sick and poor went to die. As medicine advanced, it became cleaner, safer and more effective at treating illness, but also, more expensive. Baylor Hospital, in Dallas, Texas had an idea to rebrand their image away from the macrabe by delivering babies and focusing on happier outcomes. They also wanted people to see healthcare as a commodity, therefore they began charging a small monthly fee to groups of workers, such as teachers, as a kind of medical subscription fee. They paid a dollar a month directly from their paychecks, and when they became sick, they were ensured the bill would be paid. It was a success. Workers had affordable health insurance, and Baylor hospital had a substantially larger, and more predictable revenue stream. When the Great Depression began in 1929, hospitals across the nation saw a drop in their clientele and sales. As a result, the Baylor subscription idea became immensely popular, soon spreading to every state. Baylor would go on to become the insurance company Blue Cross. If Baylor/ Blue Cross was the birth of private employer based health insurance and the depression was the catalyst that spread it, then World War II was what solidified private, employer-based private health insurance into the American healthcare system.
During World War II, president Franklin D Roosevelt implemented wage freezes, prohibiting wage increases as a way to avoid inflation, as seen in Germany after World War I. As a workaround, employers began offering private health insurance instead of competitive wages to attract employees. It worked, and shortly after in 1943, the IRS made the decision that employer based private healthcare in the United States was to be tax free. This decision was pivotal in forming today's healthcare landscape. In 1940, shortly after the start of World War II, only 9% of the population had private insurance through their employers. By 1953, 63%, and by 1960, 70% of the U.S. population would have employer based private health insurance ("Accidents Of History Created U.S. Health System"). It cannot be overemphasized that the IRS implementation of tax- free employee private insurance was crucial in the transformation of the American healthcare system. It incentivized businesses to offer healthcare instead of wages, thereby reducing their tax burden.
The journey in understanding how the American healthcare structure transformed from public interest to profiterer, continues to be explored in a Stanford article written by physician and journalist, Elisabeth Rosenthal, MD. She explains that when Blue Cross began as a non-profit organization, it was largely seen as a public good and charitable organization. They had the mission to provide affordable and effective care for all people, regardless of demographics, for the same reasonable price. Up until this point, health insurance companies, hospitals and the public had a symbiotic relationship. Then, as a growing number of people needed medical insurance, in combination with lack of government regulation, for-profit health insurance companies started aggressively marketing themselves while growing rapidly throughout the 70s and 80s. Unlike Blue Cross, these for-profit entities, such as Cigna and Aetna, did not have the same charitable mindset. They structured their health insurance using a business model, prioritizing profit and practicing risk aversion. Cigna and Aetna only covered low- risk, healthy people, offering different prices and plans for different demographics such as age and pre existing illnesses, much like life insurance would. Blue Cross was hemorrhaging money, and could not compete with this for profit business strategy. They were left with the sickest patients, and expenses that far exceeded revenue. In 1994, Blue Cross dropped their non-profit stautus, not to abandon their mission, but to access the stock market to survive and recuperate losses. It would be too late, as this was the final nail in the coffin for humanitarian health insurance. The for-profit insurance entities of Aetna, Cigna and now Blue Cross, began prioritizing investors and shareholders profits over patients by aggressively increasing premiums, delaying payouts with prior authorizations, or just outright denying claims to cover medical bills. Insurance CEOs were compensated well, into the tens of millions. (Rosenthal). Linda Peena, a health insurance medical physician turned whistleblower, talks about her time working for the for-profit health insurance company, Humana.
"As a physician working for Humana, I denied a young man a heart transplant that would have saved his life, and thus caused his death...I saved the company a half a million dollars. Humana's only concern was costs...his doctor was ready to do the operation. Meanwhile, behind the scenes Humana employees scrambled to find a loophole in the patient's contract when they did... colleagues at Humana were thrilled, even joyful. I was sickened." ("Damaged Care" Premiere Features HMO Whistleblower")
Dr. Penna's testimony demonstrates how for-profit health care in American society operates as a malignancy that prioritizes profits over people and results in the injury, illness and death of Americans. What began as a historical blunder now has extensive and far reaching effects that expands past the ledger books and into the lives and health of ordinary people.
Private equity firms are quickly taking over insurance companies, pharmaceutical companies and hospitals. They are dominating the market and becoming the industry standard with the priority to maximize profits, even at the expense of quality and accessible care. In a recent ScienceDirect article published in May of 2025, researchers Lynn Unruh and Professor Thomas Rice conducted a scoping review and found that private equity firms increased investment spending 20 fold between 2000 and 2018, amounting to tens of billions of dollars. Private equity increased their ownership in every state and in all healthcare sectors, from neonates to hospice and every specialty that lies in between. The researchers wanted to find out what effects private corporations ownership had on the United States healthcare system. The researchers noticed several key features amongst private equity firm aquistions, almost like a handbook. They were rich, they had no medical training, they invested little of their own money. When they took over healthcare facilities, they quickly restructured it in favor of profits. They dropped services for the underserved which were less profitable, and lastly, they gained power through mergers and acquisitions. The results from the study were bleak. When private equity took over surgical centers, charges increased by 50% with no improvement in patient care. When they took over hospitals, there was a 38% increase in central line infections, as well as a 25% increase in fall related injuries. When they took over, nursing home patients were 11% more likely to die. The study also noticed cost cutting behaviors such as aggressive staff cuts, increased patient loads on physicians and unnecessary procedures and hospitalizations. Private equity firms, however, did increase their profit margins. The study concluded that profit driven healthcare and high quality healthcare were incompatable (Lynn and Rice). It is evident that corporations that buy medical facilities are money-making buisnesses, with the added nuisance of having to provide healthcare. They do this by increasing prices and cutting costs and resources, even when it means patients receive worse care, becoming more ill, leading to more death. This is not an isolated issue, this is a widespread, invasive and persistent threat. For-profit healthcare is growing rapidly and becoming the standard of care in healthcare in the United States due to lack of regulations and oversight. The problem doesn't stop here. If allowed to continue, there will be long term, compounding and irreversable negative repercussions that will affect how society functions and thrives.
Long-term negative effects of for-profit medicine for the American people resulted in a worsening of what is already occurring, ultimately leading to the collapse of the American healthcare system. If for-profit healthcare and private equity firms continue to take over healthcare without intervention, there will be a continued increase in preventable illness and death due to poor medical care, further price increases, reduced access to safe and effective care (especially for the most marginalized communities). There will be an ethical decline amongst practitioners themselves as suffering is normalized, and an overall decline in trust of the medical profession as a whole. This is not a future fear, but a present and growing threat. NPR article, "Insulin's High-Cost Leads To Lethal Rationing" tells the story of a young type one diabetic named Alec. He had just aged off of his mothers health insurance plan. He made a meager 35,000 a year, too much for state insurance, but too little for decent private health insurance coverage. In just a few years, insulin prices had doubled. When Alec went to the pharmacy to pick up the insulin he needed in order to survive, he was told he could either pay $1,300 a month or pay $450 per month in premiums, with a $7,600 out of pocket cost before insurance would kick in. Alec could afford neither, so he was forced to make the decision to ration his insulin until payday. Alec died alone in his apartment from diabetic ketoacidosis, a very preventable disease, just one month after coming off of his mothers insurance ("Insulin's High Cost Leads To Lethal Rationing"). The United States is one of the richest countries in the world. The insulin Alec needed to survive was right on the other side of the counter and it cost less than 5 dollars to produce. He was allowed to die because according to for-profit healthcare his death was more profitable than his life. Stories like Alec's are not unheard of or unexpected.
In April of 2024 Brian Thompson, CEO healthcare executive was fatally shot while on his way to attend an investment conference. On the bullet casings found at the scene, were the words, "delay, deny and depose", referring to tactics health insurance companies use to avoid paying claims. The most curious part of the incident was the public reaction. It didn't matter what walk of life the person came from, their party affiliation or their stance on guns. The public intuitively and collectively understood what happened and why. Herein lies the problem; we shouldn't have understood. Americans know there's a rot in healthcare and that it should serve them better. Some attempts have been made to curb excessive corporate greed with little success.
A quick fix that has been implemented is the Affordable Healthcare Act. It aimed to increase transparency and allow wider coverage and instituted a healthcare marketplace that was not employer-dependent. It did not fix the core issue, as healthcare remained very expensive and solely for profit. According to the KFF newsletter, the affordable healthcare act plans still had a claim denial rate of 20% ("Claims Denials and Appeals in ACA Marketplace Plans in 2023"). Although complete reform was not possible, good things came out of the affordable healthcare act, such as coverage under parents health insurance until the age of 26, and decreased discrimination based on pre-existing conditions. Any amount of relief is better than none, but there still needs to be major changes in how healthcare companies provide care.
The United States can have the high-quality quality comprehensive and affordable coverage seen in Taiwan, while having the innovation that Switzerland has.
One long-term solution would be universal basic insurance state by state or region by region, while still allowing supplemental private insurance. In this model, there would be a pilot program to study as proof of concept. It would be easier to get a region to agree to it rather than the entire country.
Another is to allow research, development, and innovation to be for-profit in the private sector. Basic insurance would cover things like preventative care, generic drugs, and hospitalizations, while private companies develop and sell cutting-edge technology like gene therapy. This will then convert to the public once companies have made a profit which recuperates for their research. There would need to be strong regulations to protect the people from the government and corporations. Such as price transparency, limiting political lobbying power, and de-incentivizing financial behaviors which harm the public both physically and financially, such as reducing healthcare staffing. Most importantly is the consideration of culture. Changing culture and how people think and feel is a more powerful driving factor than anything else. The main reason the United States won't accept universal basic healthcare, despite having public programs like Medicare, Medicaid, and Tricare is because of cultural fears of becoming a socialist state. Another reason is propaganda from groups that profit off of the system as it is. Socialism and capitalism coupling in a balanced way can be proof of a healthy and robust society. Socialism creates a minimum acceptable standard of living, while capitalism creates growth, prosperity, and innovation.
The United States for-profit healthcare system is complex, inefficient, and expensive, but more importantly harmful to the public. What began as an unintentional ripple effect of historical decisions that made sense at the time, has now become an abuse of power. Healthcare insurance companies, hospitals, and pharmaceutical companies protect profits by withholding payment for treatment and charging exorbitant and unreasonable prices to generate revenue. If left untreated, healthcare will become more expensive, deadly, and inequitable. This will result in public distrust and moral societal breakdown. The United States is a young country that will continue to shape and grow. In what direction is up to the people. First must come awareness, followed by a public demand for change.
Works Cited
Kia Freeman
Joan Snyder
English 102: Section: 10
Title: The Price for Life: A Profit-Driven Healthcare Crisis
The United States, one of the wealthiest countries in the world, spends more money on healthcare per person than any other country, yet still has the worst life expectancy, maternal death, and infant mortality rates of any other developed nation. The American healthcare system has become heavily privatized and unapologetically capitalistic. What began as a practical and resourceful way to combat wage inflation after World War II, has snowballed into a complex and unforeseen set of consequences that are now difficult to change. Today, the number one priority of pharmaceutical companies, hospitals, and insurance companies is to generate profit to keep shareholders wealthy and satisfied. Profitability and medicine are inherently incompatible. Medicine relies on altruism and integrity, while corporations often prioritize their survival at all costs, even to their own detriment, and the people who rely on it; much like a malignant tumor. Profit-driven healthcare in the United States leads to worse patient health outcomes by prioritizing financial gain over safe and effective care, resulting in increased morbidity and mortality.
"We know the health system does not work as well as it should, and we understand people's frustrations with it, no one would design a system like the one we have. And no one did. It's a patchwork built over decades."- Andrew Witty.
Most countries formed their healthcare systems deliberately. The United States, on the other hand, developed its system through a host of reactionary laws, policies and political compromises. This unintended consequence of history gave way to profit-driven healthcare and its detrimental effects. Understanding the historical context of how the American healthcare insurance industry developed is imperative in identifying the root cause of the problem and ultimately changing it. In the NPR podcast, All Things Considered, a Princeton professor and healthcare policy expert recalls the historical stumbles that led the American healthcare system down its current path. Healthcare in America had humble beginnings. Before the early 1900s, medicine was a simple, archaic, but affordable fee for service, between doctor and patient. Health insurance existed at the time, but was very uncommon. Hospitals were seen as a place where the sick and poor went to die. As medicine advanced, it became cleaner, safer and more effective at treating illness, but also, more expensive. Baylor Hospital, in Dallas, Texas had an idea to rebrand their image away from the macrabe by delivering babies and focusing on happier outcomes. They also wanted people to see healthcare as a commodity, therefore they began charging a small monthly fee to groups of workers, such as teachers, as a kind of medical subscription fee. They paid a dollar a month directly from their paychecks, and when they became sick, they were ensured the bill would be paid. It was a success. Workers had affordable health insurance, and Baylor hospital had a substantially larger, and more predictable revenue stream. When the Great Depression began in 1929, hospitals across the nation saw a drop in their clientele and sales. As a result, the Baylor subscription idea became immensely popular, soon spreading to every state. Baylor would go on to become the insurance company Blue Cross. If Baylor/ Blue Cross was the birth of private employer based health insurance and the depression was the catalyst that spread it, then World War II was what solidified private, employer-based private health insurance into the American healthcare system.
During World War II, president Franklin D Roosevelt implemented wage freezes, prohibiting wage increases as a way to avoid inflation, as seen in Germany after World War I. As a workaround, employers began offering private health insurance instead of competitive wages to attract employees. It worked, and shortly after in 1943, the IRS made the decision that employer based private healthcare in the United States was to be tax free. This decision was pivotal in forming today's healthcare landscape. In 1940, shortly after the start of World War II, only 9% of the population had private insurance through their employers. By 1953, 63%, and by 1960, 70% of the U.S. population would have employer based private health insurance ("Accidents Of History Created U.S. Health System"). It cannot be overemphasized that the IRS implementation of tax- free employee private insurance was crucial in the transformation of the American healthcare system. It incentivized businesses to offer healthcare instead of wages, thereby reducing their tax burden.
The journey in understanding how the American healthcare structure transformed from public interest to profiterer, continues to be explored in a Stanford article written by physician and journalist, Elisabeth Rosenthal, MD. She explains that when Blue Cross began as a non-profit organization, it was largely seen as a public good and charitable organization. They had the mission to provide affordable and effective care for all people, regardless of demographics, for the same reasonable price. Up until this point, health insurance companies, hospitals and the public had a symbiotic relationship. Then, as a growing number of people needed medical insurance, in combination with lack of government regulation, for-profit health insurance companies started aggressively marketing themselves while growing rapidly throughout the 70s and 80s. Unlike Blue Cross, these for-profit entities, such as Cigna and Aetna, did not have the same charitable mindset. They structured their health insurance using a business model, prioritizing profit and practicing risk aversion. Cigna and Aetna only covered low- risk, healthy people, offering different prices and plans for different demographics such as age and pre existing illnesses, much like life insurance would. Blue Cross was hemorrhaging money, and could not compete with this for profit business strategy. They were left with the sickest patients, and expenses that far exceeded revenue. In 1994, Blue Cross dropped their non-profit stautus, not to abandon their mission, but to access the stock market to survive and recuperate losses. It would be too late, as this was the final nail in the coffin for humanitarian health insurance. The for-profit insurance entities of Aetna, Cigna and now Blue Cross, began prioritizing investors and shareholders profits over patients by aggressively increasing premiums, delaying payouts with prior authorizations, or just outright denying claims to cover medical bills. Insurance CEOs were compensated well, into the tens of millions. (Rosenthal). Linda Peena, a health insurance medical physician turned whistleblower, talks about her time working for the for-profit health insurance company, Humana.
"As a physician working for Humana, I denied a young man a heart transplant that would have saved his life, and thus caused his death...I saved the company a half a million dollars. Humana's only concern was costs...his doctor was ready to do the operation. Meanwhile, behind the scenes Humana employees scrambled to find a loophole in the patient's contract when they did... colleagues at Humana were thrilled, even joyful. I was sickened." ("Damaged Care" Premiere Features HMO Whistleblower")
Dr. Penna's testimony demonstrates how for-profit health care in American society operates as a malignancy that prioritizes profits over people and results in the injury, illness and death of Americans. What began as a historical blunder now has extensive and far reaching effects that expands past the ledger books and into the lives and health of ordinary people.
Private equity firms are quickly taking over insurance companies, pharmaceutical companies and hospitals. They are dominating the market and becoming the industry standard with the priority to maximize profits, even at the expense of quality and accessible care. In a recent ScienceDirect article published in May of 2025, researchers Lynn Unruh and Professor Thomas Rice conducted a scoping review and found that private equity firms increased investment spending 20 fold between 2000 and 2018, amounting to tens of billions of dollars. Private equity increased their ownership in every state and in all healthcare sectors, from neonates to hospice and every specialty that lies in between. The researchers wanted to find out what effects private corporations ownership had on the United States healthcare system. The researchers noticed several key features amongst private equity firm aquistions, almost like a handbook. They were rich, they had no medical training, they invested little of their own money. When they took over healthcare facilities, they quickly restructured it in favor of profits. They dropped services for the underserved which were less profitable, and lastly, they gained power through mergers and acquisitions. The results from the study were bleak. When private equity took over surgical centers, charges increased by 50% with no improvement in patient care. When they took over hospitals, there was a 38% increase in central line infections, as well as a 25% increase in fall related injuries. When they took over, nursing home patients were 11% more likely to die. The study also noticed cost cutting behaviors such as aggressive staff cuts, increased patient loads on physicians and unnecessary procedures and hospitalizations. Private equity firms, however, did increase their profit margins. The study concluded that profit driven healthcare and high quality healthcare were incompatable (Lynn and Rice). It is evident that corporations that buy medical facilities are money-making buisnesses, with the added nuisance of having to provide healthcare. They do this by increasing prices and cutting costs and resources, even when it means patients receive worse care, becoming more ill, leading to more death. This is not an isolated issue, this is a widespread, invasive and persistent threat. For-profit healthcare is growing rapidly and becoming the standard of care in healthcare in the United States due to lack of regulations and oversight. The problem doesn't stop here. If allowed to continue, there will be long term, compounding and irreversable negative repercussions that will affect how society functions and thrives.
Long-term negative effects of for-profit medicine for the American people resulted in a worsening of what is already occurring, ultimately leading to the collapse of the American healthcare system. If for-profit healthcare and private equity firms continue to take over healthcare without intervention, there will be a continued increase in preventable illness and death due to poor medical care, further price increases, reduced access to safe and effective care (especially for the most marginalized communities). There will be an ethical decline amongst practitioners themselves as suffering is normalized, and an overall decline in trust of the medical profession as a whole. This is not a future fear, but a present and growing threat. NPR article, "Insulin's High-Cost Leads To Lethal Rationing" tells the story of a young type one diabetic named Alec. He had just aged off of his mothers health insurance plan. He made a meager 35,000 a year, too much for state insurance, but too little for decent private health insurance coverage. In just a few years, insulin prices had doubled. When Alec went to the pharmacy to pick up the insulin he needed in order to survive, he was told he could either pay $1,300 a month or pay $450 per month in premiums, with a $7,600 out of pocket cost before insurance would kick in. Alec could afford neither, so he was forced to make the decision to ration his insulin until payday. Alec died alone in his apartment from diabetic ketoacidosis, a very preventable disease, just one month after coming off of his mothers insurance ("Insulin's High Cost Leads To Lethal Rationing"). The United States is one of the richest countries in the world. The insulin Alec needed to survive was right on the other side of the counter and it cost less than 5 dollars to produce. He was allowed to die because according to for-profit healthcare his death was more profitable than his life. Stories like Alec's are not unheard of or unexpected.
In April of 2024 Brian Thompson, CEO healthcare executive was fatally shot while on his way to attend an investment conference. On the bullet casings found at the scene, were the words, "delay, deny and depose", referring to tactics health insurance companies use to avoid paying claims. The most curious part of the incident was the public reaction. It didn't matter what walk of life the person came from, their party affiliation or their stance on guns. The public intuitively and collectively understood what happened and why. Herein lies the problem; we shouldn't have understood. Americans know there's a rot in healthcare and that it should serve them better. Some attempts have been made to curb excessive corporate greed with little success.
A quick fix that has been implemented is the Affordable Healthcare Act. It aimed to increase transparency and allow wider coverage and instituted a healthcare marketplace that was not employer-dependent. It did not fix the core issue, as healthcare remained very expensive and solely for profit. According to the KFF newsletter, the affordable healthcare act plans still had a claim denial rate of 20% ("Claims Denials and Appeals in ACA Marketplace Plans in 2023"). Although complete reform was not possible, good things came out of the affordable healthcare act, such as coverage under parents health insurance until the age of 26, and decreased discrimination based on pre-existing conditions. Any amount of relief is better than none, but there still needs to be major changes in how healthcare companies provide care.
The United States can have the high-quality quality comprehensive and affordable coverage seen in Taiwan, while having the innovation that Switzerland has.
One long-term solution would be universal basic insurance state by state or region by region, while still allowing supplemental private insurance. In this model, there would be a pilot program to study as proof of concept. It would be easier to get a region to agree to it rather than the entire country.
Another is to allow research, development, and innovation to be for-profit in the private sector. Basic insurance would cover things like preventative care, generic drugs, and hospitalizations, while private companies develop and sell cutting-edge technology like gene therapy. This will then convert to the public once companies have made a profit which recuperates for their research. There would need to be strong regulations to protect the people from the government and corporations. Such as price transparency, limiting political lobbying power, and de-incentivizing financial behaviors which harm the public both physically and financially, such as reducing healthcare staffing. Most importantly is the consideration of culture. Changing culture and how people think and feel is a more powerful driving factor than anything else. The main reason the United States won't accept universal basic healthcare, despite having public programs like Medicare, Medicaid, and Tricare is because of cultural fears of becoming a socialist state. Another reason is propaganda from groups that profit off of the system as it is. Socialism and capitalism coupling in a balanced way can be proof of a healthy and robust society. Socialism creates a minimum acceptable standard of living, while capitalism creates growth, prosperity, and innovation.
The United States for-profit healthcare system is complex, inefficient, and expensive, but more importantly harmful to the public. What began as an unintentional ripple effect of historical decisions that made sense at the time, has now become an abuse of power. Healthcare insurance companies, hospitals, and pharmaceutical companies protect profits by withholding payment for treatment and charging exorbitant and unreasonable prices to generate revenue. If left untreated, healthcare will become more expensive, deadly, and inequitable. This will result in public distrust and moral societal breakdown. The United States is a young country that will continue to shape and grow. In what direction is up to the people. First must come awareness, followed by a public demand for change.
Works Cited
