Can You Afford Good Healthcare? The Hidden Costs No One Talks About

Last week, I had two medical tests. Walking into the hospital, I thought, “Can there really be a healthcare problem? This place is packed—people seem to be getting the care they need.” I was pretty confident that, between the ACA (Affordable Care Act) and insurance, the system was working. But then, bam—$100 for the first test. Wham—another $100 for the second. Suddenly, I was down two hundred dollars, just like that. A follow-up visit the next day? Kapow—another $40.

That’s two hundred forty dollars in less than 24 hours, with insurance. If I’m feeling this pinch, what about everyone else in that crowded waiting room? How are these costs affecting them? I started to wonder: Is there really a problem with healthcare, or am I just unlucky? So, I did some digging—and what I found wasn’t pretty. Spoiler alert: Yes, there’s a big problem.

The Affordable Care Act: A Band-Aid on a Broken System

The ACA (or “Obamacare”) was introduced to make health insurance more affordable and accessible for millions of Americans. And, to be fair, it’s helped many people who were previously uninsured. It banned things like denying coverage for pre-existing conditions, and expanded Medicaid to cover more low-income individuals. But here’s the catch: the ACA didn’t fix the core issue—healthcare costs are still too high.

Even with ACA insurance plans, many people are still facing high deductibles, co-pays, and narrow provider networks. Some “affordable” plans mean you pay lower premiums, but the out-of-pocket costs can skyrocket when you actually need care. For people with chronic conditions or families needing regular check-ups, the financial burden adds up fast.

So, if the ACA is supposed to help, why isn’t it enough?

Why Healthcare Is Still Expensive (Even with Insurance)

The U.S. healthcare system is designed to be a business. And like any business, there are many players with their own interests—hospitals, pharmaceutical companies, and, of course, insurance companies. All of them need to turn a profit, and guess where a lot of that profit comes from? Us, the patients.

Here are a few reasons costs are still so high:

1. High Deductibles and Out-of-Pocket Costs: Many ACA plans come with high deductibles. You might pay less each month for insurance, but when you actually need care, the costs can be shocking. Before your insurance kicks in, you’re expected to cover these expenses yourself, which can total thousands of dollars a year.

2. Prescription Drug Prices: Americans pay more for prescription drugs than people in any other developed country. Why? Because pharmaceutical companies can set their prices as high as they want in the U.S., and there are few regulations to stop them. Countries with universal healthcare systems negotiate drug prices on behalf of their citizens—something we don’t do here.

3. Limited Coverage and Networks: Some ACA plans come with narrow networks, meaning fewer doctors and specialists to choose from. If you need to go out of network for care—whether you know it or not—you could be hit with a surprise bill that your insurance won’t cover.

4. Administrative Costs: A huge chunk of healthcare spending goes to the cost of just running the system—processing claims, dealing with insurance paperwork, handling disputes, and so on. A universal system could eliminate a lot of this red tape, but the complexity of our current system keeps costs high.

Why Don’t Insurance Companies Want Universal Healthcare?

Here’s where it gets tricky. Insurance companies don’t like universal healthcare because it would put them out of business—or at least severely limit their role. In a universal healthcare system (like those in Canada or the U.K.), the government takes over most of the insurance role. Taxes go up to fund the system, but patients pay little or nothing at the point of care. There’s no need for private insurance for most basic services because the government covers it all. That means fewer customers and less profit for insurance companies.

In 2020 alone, the top five health insurance companies in the U.S. made over $60 billion in profits combined. So it’s no surprise that these companies don’t want a system that cuts them out of the equation.

Opposing Views on Universal Healthcare

Of course, not everyone agrees that universal healthcare is the solution. Here’s what opponents argue:

1. Higher Taxes: Critics point out that universal healthcare would likely mean higher taxes to fund the system. They argue that this would place a burden on middle- and upper-income individuals and businesses, ultimately harming economic growth.

2. Longer Wait Times: One of the most common concerns is that universal healthcare could lead to longer wait times for certain treatments, especially elective surgeries. Opponents often cite examples from countries like Canada, where wait times for non-urgent procedures can be months long.

3. Reduced Innovation: Another argument is that universal healthcare would stifle innovation in the medical field. Critics believe that competition in the private insurance market drives healthcare providers to innovate, and they fear a government-run system would lack the same incentive to push boundaries in medical research and technology.

The Impact of Poor Health on Productivity and Why Better Health Is Better Business

Here’s something that’s often overlooked in the debate about healthcare: healthy people are productive people. When access to healthcare is limited or unaffordable, people skip preventative care, delay treatment, and end up sicker in the long run. And when people are unhealthy, their productivity drops—meaning more sick days, lower work performance, and higher costs for employers. In fact, it’s estimated that poor employee health costs U.S. businesses more than $530 billion annually in lost productivity.

Let’s think about it from a business perspective:

1. Fewer Sick Days: When employees have affordable access to preventative care, they’re more likely to catch health issues early, leading to fewer sick days and higher attendance.

2. Better Job Performance: Healthy employees are more focused, energetic, and productive. Chronic health issues like untreated diabetes, hypertension, or even stress and anxiety can drag down job performance. On the flip side, people who have access to regular care are more likely to stay healthy and engaged at work.

3. Lower Healthcare Costs for Employers: Right now, many companies provide health insurance for their employees—and the costs are rising. By some estimates, employers are spending over $15,000 per employee on health insurance. If we had a universal healthcare system, businesses could potentially save billions in healthcare expenses while also ensuring a healthier, more productive workforce.

4. Economic Growth: Healthy citizens are more likely to participate in the workforce, contribute to the economy, and spend money. When people aren’t drowning in medical debt or worrying about how to pay for their next prescription, they have more financial freedom. In fact, some economists argue that a healthier population boosts overall economic productivity and helps drive innovation in other sectors.

So, while the argument against universal healthcare often centers on cost, it’s important to look at the big picture: a healthier population could actually help grow the economy and reduce long-term costs for businesses.

Where Do We Go From Here?

The debate around healthcare reform in the U.S. is far from over, but it’s clear that the current system leaves too many people struggling to afford the care they need. Universal healthcare offers a potential solution—one where healthcare is accessible and affordable for everyone.

In the meantime, there’s an urgent need for reforms that tackle the immediate issues: lowering prescription drug prices, reducing deductibles, and expanding coverage networks so people don’t have to gamble with their health or their bank accounts.

I walked into that hospital thinking healthcare wasn’t a problem, but I walked out with a different perspective—and a lighter wallet.

What’s your experience with healthcare costs? Share your story in the comments, and let’s keep the conversation going. If you believe healthcare should be more affordable and accessible for everyone, consider reaching out to your local representatives or supporting organizations pushing for reform. The more we talk about it, the closer we get to real solutions.