skyrocketing expenses and glaring disparities define the US healthcare system

Revamped Article:

Health Care in America vs. the Rest of the World - Unraveling the Profit-Driven, Fragmented System

Authored by Dr. Zach Schulz, History Instructor, Auburn University

Get the Scoop:

Ever wondered why you're stuck in a healthcare mess with sky-high costs, tons of paperwork, and little relief in sight? My friend, you ain't alone. The system has been carefully constructed to serve the privileged few, with private interests, political games, and bias playing star roles in its creation. Buckle up as we delve into the nitty-gritty of the American healthcare system - or lack thereof.

Historian's Perspective:

As a historian specializing in public health, I've spent my days sifting through the gunk of policy choices that've molded healthcare, particularly in the Deep South. One question perpetually buzzes in my brain: Why is our system a tangled mess while other countries provide quality care without the headaches?

Well, I shall break it down for ya, mate.

Go Back in Time:

Our healthcare predicament dates back to the mid-20th century. Our government, dodging responsibility, pushed employers to offer insurance benefits. This move, made as a tax workaround during World War II wage freezes, bound healthcare access to employment status. And since then, it's been a never-ending nightmare. It's worth noting that countries with similar systems, like the employer-provided insurance model, typically combine it with bold public options, ensuring that access isn't tied to a job.

Then come the 1960s, when Medicare and Medicaid popped up. Medicare, for folks 64 and up, was an upgrade for wealthier Americans with decent jobs and benefits, while Medicaid, a joint federal-state program, aimed at the poor. The result? Fifty unique programs with varying eligibility, coverage, and quality, often blocked by lawmakers to maintain racial hierarchies during the Jim Crow era.

Bureaucracies Galore:

Fast forward to today, and you've got states gripping onto power, refusing to expand Medicaid under the Affordable Care Act. Those same refusals mostly hit Southern states, including those with large Black populations. Couple that with the fact that about 1 in 4 uninsured Black adults are locked out of accessing affordable health insurance, and call it a recipe for disaster.

You might end up getting care, but only after wading through opaque billing codes, networks, and formularies, all while trying to beat off illness or maintain your health. Scholars like myself believe this complex process is anything but an accident - rather, a deliberate move to ensure profits for insurers and intermediaries at your expense.

Politics as Usual:

Culturally entrenched attitudes, like rugged individualism and the sham of freedom of choice, have long been used to resist public health solutions. You see, back in the postwar days, while European nations built national health care systems, the U.S. kept courting a market-driven approach. Politicians and industry leaders attacked public funding as a threat to individual freedom, usually slapping on the "socialized medicine" label.

Catching Up:

Other countries' healthcare systems vary widely in structure, but all strive for universal access and transparency. Countries like Germany, France, and Canada show us that alternatives exist, so it's high time we started demanding one. Only when we understand the flaws within our system, recognize its design, and confront the layers of profit, politics, and prejudice can we truly imagine and fight for a better, fairer system. So, my fellow Americans, let's get informed, get frustrated, and get ready to change the game.

First appeared on The Conversation, June 6th, 2025 under a Creative Commons Attribution/No derivatives license.

Keep It Real:

The roots of today's healthcare maladies stem from compromises prioritizing private markets, protecting racial hierarchies, and elevating individual responsibility over collective well-being.
The introduction of Medicare and Medicaid in the 1960s deepened inequalities, as wealthy Americans primarily benefited from Medicare, while Medicaid, designed for the poor, became a patchwork of varying programs with different eligibility, coverage, and quality.
The rise of private insurers, state-run Medicaid programs, and fragmented billing systems led to increased complexity, with patients expected to navigate confusing billing codes, networks, and formularies.
Cultural attitudes around liberty and individualism have long been leveraged to resist public solutions, with the fear-mongering of "socialized medicine" or the threat of creeping socialism used to discourage progress.
While reforms like the Affordable Care Act have attempted to expand access, they have often preserved underlying inequalities and inequities, relying on private insurers to maintain their role in the system.
The complex and fragmented healthcare system in America, riddled with high costs and paperwork, can be traced back to compromises in the mid-20th century that prioritized private markets and individual responsibility over collective well-being.
The introduction of Medicare and Medicaid in the 1960s, though designed to provide healthcare to different income groups, resulted in various programs with differing eligibility, coverage, and quality, exacerbating inequalities.
As a result, patients in the American healthcare system must navigate through convoluted billing codes, networks, and formularies in their quest for healthcare, a complexity arguably deliberate to ensure profits for insurers and intermediaries at the expense of patients.