Debt, crowdfunding, or death: America's very broken healthcare system

The United States is the only industrialized nation in the world without universal healthcare. Instead, Americans are forced to rely on a mixture of profit and nonprofit private and public healthcare insurers and providers. The United States federal government provides healthcare coverage through Medicare to individuals ages 65 years and older, and to some individuals with disabilities, military veterans, and children through Medicaid and the Children’s Health Insurance Program (CHIP).

Around 26 million Americans, about 8% of the population, including just under 2% of children, have no health insurance coverage at all. Low-income families are more likely to be uninsured, with the high cost of health insurance cited as the main factor as to why people remain uninsured in the US. The lack of coverage significantly worsens Americans’ access to health care and many face unaffordable out-of-pocket medical bills if they do seek care.

A 2009 study by Harvard Medical researchers found that 45,000 Americans die every year directly as a result of not having health insurance. 13% of Americans, about 34 million people, reported in a 2019 Gallup poll that they had a friend or family member pass away prematurely after being unable to afford medical care.

$1,055 per person in the US was spent solely on administrative costs, compared to $97 per person in the UK. A 2019 analysis by the Center for American Progress estimated the US spends $248 billion on excess healthcare administrative costs annually. The significant healthcare spending costs in the US do not translate to better health outcomes; life expectancy in the US in 2021 was 76.1 years and the US ranks behind other wealthy countries in performance metrics for health care outcomes. The US spends less per person on long-term healthcare costs than the average for OECD countries.

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