In search of clarity on the escalating costs of healthcare in America, we’ve gathered insights from eight industry experts, including COOs and Physicians.

From the burden of being underinsured to paying higher costs due to a lack of transparency, these leaders dissect the complexities behind why Americans are digging deeper into their pockets for healthcare.

• Underinsurance Burdens Americans
• Administrative Costs Dominate Bills
• Palliative Care’s Rising Costs
• Outdated Systems Inflate Expenses
• Rising Prices Strain the Healthcare System
• Administrative Hassles Increase Costs
• Complex Laws Complicate Healthcare
• Lack of Transparency Leads to Higher Costs

Underinsurance Burdens Americans

Evan Tunis, President, Florida Healthcare Insurance

A major reason why Americans are paying more for healthcare is that a large number of them are underinsured. Underinsurance occurs when individuals have health insurance that does not cover all necessary medical expenses, leaving them with high out-of-pocket costs. 

This can be due to high deductibles, copayments, or exclusions in coverage. As a result, underinsured Americans are forced to pay more for healthcare because they are responsible for a larger portion of the costs. 

This can be financially burdensome and lead to individuals forgoing necessary medical treatments or racking up medical debt. With approximately 45 million Americans considered underinsured, it is clear that this issue plays a significant role in driving up healthcare costs in the United States.

Administrative Costs Dominate Bills

Elisha Peterson MD MED FAAP FASA, Anesthesiologist and Pain Medicine Physician, Elisha Peterson MD PLLC

A stark reality underpinning rising healthcare costs in America is the disheartening revelation that a significant portion of individuals’ hospital bills isn’t directed toward the medical services they receive. 

Rather, the majority is absorbed by administrative costs. It’s disconcerting for many Americans to learn that their hard-earned dollars primarily fund middlemen who don’t deliver direct healthcare services and have no medical expertise. 

This skewed allocation of resources underscores a systemic issue, emphasizing the need for a reevaluation of healthcare structures to ensure that the financial burden borne by individuals aligns more closely with the actual provision of medical care. 

Addressing this imbalance is crucial for steering healthcare toward a more transparent, patient-centric model that prioritizes genuine health services over administrative overhead.

Palliative Care’s Rising Costs

Trevor Ewen, COO, QBench

Palliative care is very expensive. There are two main drivers of this expense and its continued growth. Prevention and lifestyle interventions are underrated or ignored. This results in palliative care situations that could have been stopped earlier. 

The medical system has been slow to adopt the efficiencies that drive cost reduction in other businesses. The vast majority are operational improvements and continuous innovation that would not be strange to Amazon or Toyota but do seem to elude our healthcare system.

Outdated Systems Inflate Expenses

Nooran Zafarmand, Co-Founder and CEO, Japamana

As the CEO of an education company that studies international models, I realize another large factor contributing to the higher healthcare costs in America is outdated healthcare systems and bureaucracy. 

It’s like trying to run modern software on a decades-old computer; we are incurring avoidable expenses through layers of administrative costs, cumbersome paperwork, and delays in care delivery. 

By streamlining operations and adopting systems similar to the modern, smooth-running, cost-effective frameworks that countries like Japan employ, we could significantly lower our healthcare expenses.

Rising Prices Strain the Healthcare System

Johannes Larsson, Founder and CEO, JohannesLarsson.com

One significant reason why Americans are paying more for healthcare is the escalating costs of medical procedures and prescription drugs. 

The complex interplay between pharmaceutical companies, healthcare providers, and insurance companies has led to a situation where the prices of treatments and medications are on the rise. This puts a strain on individual wallets and contributes to the overall burden on the healthcare system.

Although I don’t permanently live in the USA, I think it’s essential to advocate for transparency and efficiency in the industry. Citizens and companies alike should seek innovative solutions that enhance accessibility and affordability without compromising the quality of care.

Administrative Hassles Increase Costs

James Cunningham, Senior Coach, Total Shape

One major reason Americans are shelling out more for healthcare is the administrative hassle. The whole system is like a paperwork jungle—from insurance claims to billing codes, it’s a mess. Every twist and turn in the bureaucratic red tape adds another layer of cost. 

Doctors are drowning in paperwork, and the more time they spend on that, the less time they have for, you know, actual patient care. It’s like we’re paying for a bureaucratic circus instead of the medical attention we actually need.

Complex Laws Complicate Healthcare

Martin Gasparian, Attorney and Owner, Maison Law

Americans’ healthcare costs are rising because healthcare laws are convoluted and hard to grasp. The US healthcare law is complex. This has made the system costly and complicated.

Along with healthcare laws, several insurance and pharmaceutical cost rules exist. Due to the complex laws, healthcare providers, insurers, and customers pay more. Businesses must pay extra for things like hiring a lawyer to help them understand the requirements and buying systems that ensure they obey all healthcare laws to stay in compliance.

Legal issues can hinder healthcare price negotiations. Healthcare professionals must follow several billing, charging, and payment rules. Medical providers, insurers, and drug firms form laws, which affect healthcare costs.

The American legal system contributes to many healthcare disputes. Healthcare providers need liability insurance beyond malpractice claims. Defensive medicine in the judicial system has raised healthcare expenses.

Lack of Transparency Leads to Higher Costs

Keith Sant, Founder and CEO, Kind House Buyers

A significant factor contributing to the increased healthcare costs in America is the absence of price transparency within the healthcare industry. This means that patients are not able to easily access information about the prices of medical procedures, medications, and services. 

This lack of price transparency leads to a lack of competition within the healthcare market. Without knowing the cost of different options, patients are unable to make informed decisions about their healthcare and compare prices between different providers. 

As a result, healthcare providers are able to charge higher prices without fear of losing business. In addition, the lack of price transparency also makes it difficult for patients to budget and plan for healthcare costs. 

Without knowing how much they will be charged for medical procedures or services, patients may be caught off guard by unexpected expenses, leading to financial strain and stress.