Author Biography

Spencer Atkisson attended Utah State University for his freshman year of college. After being born in Chicago and growing up in San Francisco, Spencer spent a few-month stint in rural Mexico before moving to London halfway through high school. Through these experiences stemming from moving internationally Spencer has been able to find plentiful inspiration for his writing. An avid traveller, he has visited 19 countries, many of which have been done travelling solo or with friends. He has applied to transfer back to European universities for his sophomore year and hopes to relocate there permanently.

This essay was composed in March 2023 and uses MLA documentation.

Every time the reasons were different, but the outcome was the same. Some change in provider, renewal of a prescription or change in regulation would cause United Healthcare, our health insurance provider to deny another shipment of insulin for my type 1 diabetic sister. At 10 pm at night I’d see my mom, who had been on the phone with United Healthcare since 11 am that morning, trying to secure another shipment of insulin for my sister whose supplies were dwindling to dangerously low levels. After hours of arguing and dragging their feet, the representative would grudgingly agree to restart monthly shipments. Death had been postponed again, but only until the insurance providers decided they wanted to cut shipments again. Our insurance would repeat this cycle every few months for over 5 years. This pattern of staying one-step ahead of death is a struggle many Americans face, and is made even more difficult when patients have to fight their insurance as much as their illness.

My family has had many experiences dealing with the United States’ healthcare system, with illnesses including Type 1 Diabetes, Hashimoto’s, Celiacs, Crohn’s, Multiple Sclerosis, Cancer cases, and mental illness existing within our family. When I was 16 our medical bills became so great we could no longer afford to stay in San Francisco after living there for 14 years. My Dad was subsequently laid off from his job during the start of the COVID pandemic and the looming loss of insurance coverage had the threat of wiping out our savings. The threat of bankruptcy due to medical expenses is not unique; of the two million personal bankruptcies filed yearly in the US, 62% are due to medical expenses (American Bankruptcy Institute). After a long job search, my Dad ended up landing a position working in London, England. Leaving my childhood home for the last time and moving 5,300 miles away is something I will never forget. Moving was a flurry of change, and I remember those first few months being a blur. After the stress from moving to a new country settled down, I realized there had been a distinct lack of stress about healthcare since moving. Soon after our arrival into the UK, we began receiving regular shipments of insulin for my sisters from the UK’s state run healthcare system, the National Health Service (referred to as the NHS). Not only was there little hassle in getting deliveries and no interruptions in coverage, everything was free of charge. As the months went by relying on this new system, I developed a solid trust in it. Having faith in the system that was keeping my family members alive was a completely novel experience for me. All of the constant anxiety I grew up with about medical bills and getting the medicines we needed seemed to disappear. It felt as if an entire dimension of stress had simply ceased to exist. Realizing this, I started to question the validity of the United States’ healthcare system. However, the starkest contrast I found in patient treatment came a year after the move. In late February of 2022, my Dad had an unexpected diagnosis of stage 4 melanoma with tumors in his brain, lymph nodes, and spine. The doctors decided the best course of action would be a newly-approved mixed method of immunotherapy and chemo. Even though the treatment was newly-approved and very expensive, the cost was fully covered. Moreover, all of his other prescriptions unrelated to the cancer had their usual £9 fee (the maximum price of a monthly prescription in the UK) waived. I remember the day after my dad was released from a particularly brutal two week hospital stay I woke up to find a pallet full of cream-colored protein drink bottles on our doorstep. The protein shakes (which were originally meant for bodybuilders) were delivered to help with his recovery after chemotherapy. Not only had the NHS covered the price of the treatment and prescriptions, but also delivered and paid for store-bought items he’d need to get healthy again. Seeing this drew a stark contrast to seeing my Mom spend entire weekends on the phone battling a for-profit corporation for medicine my sister needed to live another two weeks. Paying tens of thousands of dollars out of pocket would have been necessary had this diagnosis occurred only a few years earlier.

The immunotherapy/chemotherapy my Dad was treated with costs around 100,000-150,000 dollars per patient in the United States (Pietrangelo). The American healthcare industry overall is estimated to have cost Americans a total of $4.3 trillion in 2021, or around $12,914 per capita yearly (Insider Intelligence). Conversely, the total estimated healthcare expenditure for the United Kingdom was only around £220 billion including covid funding (BMA&NHS), which works out to about £3,236 per capita (Statista). This converts to around $4,000 USD yearly. Some may wonder if the lower expenditure leads to worse health outcomes or lower quality care. However, in 2019 the United Kingdom had approximately 194 avoidable deaths per 100,000 people compared to the United States’ 273 (Commonwealth Fund). Switzerland had 130, less than half of the USA’s rate. How is it that the UK spends a quarter of the cost per patient than the USA yet still has better health outcomes? Taking a look at the finances of the United States’ largest healthcare providers is a great place to start. United Healthcare, the largest healthcare company in the United States, has a market capitalization of around 461.8 Billion dollars at the time of writing (NYSE). This is higher than massive global conglomerates such as Meta, Walmart, Samsung, and Toyota. Larger even than Disney and Coca-Cola combined. This is unique as United Healthcare is the only company among those listed that doesn’t actually produce anything for society. All of the value and profit an American healthcare company receives comes from bills we pay to keep ourselves alive. Due to the massive amounts of money being funneled into the pockets of these middlemen, the American healthcare industry is by far the most expensive in the developed world (McGough).

By structuring our healthcare system around private healthcare companies, every dollar an insurance company spends on a patient’s care comes directly out of their profit. This incentivizes the insurers, who we’ve anointed our gatekeepers of life, to charge as much as they can and keep as many resources for themselves as possible. Insurance companies receive direct financial gain by providing as little care and aid as they can as it means less money out of their own pocket. While the free market and capitalism in general can at times provide immense growth and innovation in competitive industries, putting essentials like healthcare in a market economy creates an environment ripe for exploitation. Though it may be possible to regulate companies such that they behave in a more moral manner, by centralizing healthcare operations through a government agency many of the financial inefficiencies in our current system cease to exist (Gray). Inefficiencies in our current system are vast and numerous, but a few of the most glaring include pharmaceutical marketing, sales, and executive bonuses. Every single ad we see on TV for a medicine or treatment comes from our pocket. We pay insurers to buy medicines from companies, which offset the cost of their advertising along with many other factors in the price of their drug. We essentially pay to see ads as part of our medical bills. Additionally, every pharmaceutical company has large, well funded sales teams whose job it is to sell their medicines and services. All of the paychecks and costs for all of these marketing and sales departments is another thing that we pay for in our bills. This simply wouldn’t exist in a system where care is given out to those who need it, instead of advertised and sold to those who might. Medicine is not something that should be advertised and sold like a luxury handbag, but an essential good that should be provided to those who require it. The healthcare industry provides a rare example of a situation where encouraging a free market creates a more expensive market overall. Though eliminating private competition may seem like it would increase cost and lower incentives to innovate and lower prices, comparison of different global systems shows that getting rid of most private profit from the healthcare system reclaims enough money back into the public good to offset the cost of government bureaucracy (Gray).

Unfortunately in February of this year my family received the terrible news that my Dad’s cancer had reappeared as terminal after previously going into remission. Though it has been a whirlwind of pain and emotional turmoil, I can’t imagine how someone might go through the same situation while also worrying about bankruptcy. The fact that people in our country go bankrupt for the act of attempting to stay alive is something we should not, and can not continue to accept. When our healthcare system makes patients worry more about their coverage more than their illness, we defeat the purpose of our healthcare system in the first place. The effects of dozens of companies making massive profits on our attempts to be healthy significantly increase the costs and inefficiencies of providing care. Consequently, our healthcare system is more expensive and less effective than any other industrialized nation. If millions of Americans can’t access or afford adequate care due to the status quo, one could argue our status quo is a public health hazard itself. Though massive change in a critical industry is something that should be met with caution and trepidation, it would be a grave mistake to not attempt to create a better, healthier future.

Works Cited

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