Introduction
The American healthcare system, often heralded as a leader in medical innovation, paradoxically fails to serve the needs of the average person. Despite the United States spending more on healthcare per capita than any other developed nation—approximately $12,555 per person in 2022 according to the Centers for Medicare & Medicaid Services—the outcomes for many citizens remain poor, with millions unable to access timely care or facing financial ruin due to medical expenses. This essay seeks to persuade the reader that the American healthcare system is fundamentally flawed in meeting the needs of ordinary individuals. It will focus on three critical areas: the prohibitive upfront costs and accessibility barriers, the pervasive issue of medical debt, and the systemic unequal and unfair treatment of patients. By examining these issues through a critical lens, supported by verifiable evidence, this discussion aims to highlight the urgent need for reform to ensure equitable healthcare for all Americans.
Upfront Costs and Accessibility Barriers
One of the most significant failures of the American healthcare system is the prohibitive upfront costs that restrict access for many citizens. Unlike countries with universal healthcare systems, such as the United Kingdom, where the National Health Service (NHS) provides care free at the point of use, the U.S. relies heavily on private insurance and out-of-pocket payments. According to a 2021 report by the Commonwealth Fund, approximately 8.6% of Americans—roughly 28 million people—were uninsured, meaning they must pay the full cost of medical services or forego care altogether (Collins et al., 2021). Even for those with insurance, high deductibles and co-payments often deter individuals from seeking necessary treatment. For instance, a basic primary care visit can cost between $150 and $300 without insurance, a sum that is simply unaffordable for low-income households (Berchick et al., 2019).
Furthermore, accessibility is compounded by geographic disparities. Rural areas in the U.S. often lack adequate healthcare facilities, with hospital closures becoming increasingly common—over 140 rural hospitals have closed since 2010 (Kaufman et al., 2020). This leaves millions without timely access to emergency care or routine medical services. Indeed, the upfront financial burden and limited physical access create a system where healthcare is a privilege rather than a right, disproportionately affecting the average person who lacks the means to navigate these barriers.
Medical Debt as a Systemic Burden
Another profound failure of the American healthcare system is the crippling medical debt that ensnares countless individuals. Medical expenses are the leading cause of personal bankruptcy in the U.S., with a 2021 study estimating that around 530,000 families file for bankruptcy each year due to healthcare costs (Himmelstein et al., 2021). This statistic is particularly striking when contrasted with countries like the UK, where such debt is virtually unheard of due to public funding of healthcare. In the U.S., even insured individuals are not immune; high-deductible plans and unexpected out-of-network charges can result in bills amounting to thousands of dollars. For example, a single hospital stay for a non-complex procedure can average $10,000 or more, often leaving patients with debt they cannot realistically repay (Kaiser Family Foundation, 2022).
The consequences of medical debt extend beyond financial ruin. Individuals burdened by such debt often delay or avoid further medical care, exacerbating health conditions and creating a vicious cycle of deteriorating health and mounting costs. This systemic issue reveals a healthcare framework that prioritises profit over people, failing the average American who is one illness away from financial catastrophe. Arguably, this reality underscores the need for a reevaluation of how healthcare costs are distributed and managed in the United States.
Unequal and Unfair Treatment Across Demographics
The American healthcare system also fails the average person through its perpetuation of unequal and unfair treatment, particularly across racial, socioeconomic, and gender lines. Disparities in health outcomes are well-documented; for instance, Black Americans have a life expectancy approximately five years lower than their White counterparts, largely due to systemic inequities in access to quality care (Arias et al., 2021). Studies have shown that minority groups are less likely to receive timely interventions for chronic conditions such as diabetes or hypertension, often due to implicit bias among providers or lack of culturally competent care (Williams and Mohammed, 2013).
Additionally, socioeconomic status plays a critical role in treatment disparities. Low-income individuals are more likely to receive substandard care or be denied services due to inability to pay, while wealthier patients can afford premium services and faster access. Gender-based disparities further compound the issue; women, for example, often report their pain being dismissed by healthcare providers at higher rates than men, leading to delayed diagnoses (Hoffmann and Tarzian, 2001). These inequities demonstrate a system that does not serve all Americans equally, leaving many average individuals—particularly those from marginalised groups—without the care they deserve. Therefore, addressing these disparities is not merely a matter of policy adjustment but a moral imperative.
Conclusion
In conclusion, the American healthcare system fails the average person through multiple systemic shortcomings. The prohibitive upfront costs and accessibility barriers prevent millions from obtaining essential care, while the prevalence of medical debt places an unbearable financial burden on families, often leading to bankruptcy. Moreover, the unequal and unfair treatment of patients across racial, socioeconomic, and gender lines exacerbates health disparities, undermining the principle of equity in healthcare. These issues, supported by substantial evidence, highlight a system that prioritises profit and privilege over the well-being of ordinary citizens. The implications of these failures are profound, necessitating urgent reform to shift toward a more inclusive and equitable model—potentially drawing inspiration from systems like the UK’s NHS. Without such changes, the average American will continue to bear the brunt of a healthcare system that is fundamentally unfit for purpose. As this essay has argued, acknowledging and addressing these failures is not merely an academic exercise but a critical step toward ensuring health as a universal right rather than a luxury.
References
- Arias, E., Tejada-Vera, B., and Ahmad, F. (2021) Provisional Life Expectancy Estimates for 2020. National Center for Health Statistics.
- Berchick, E. R., Barnett, J. C., and Upton, R. D. (2019) Health Insurance Coverage in the United States: 2018. U.S. Census Bureau.
- Collins, S. R., Gunja, M. Z., and Aboulafia, G. N. (2021) U.S. Health Insurance Coverage in 2020: A Looming Crisis in Affordability. The Commonwealth Fund.
- Himmelstein, D. U., Lawless, R. M., Thorne, D., Foohey, P., and Woolhandler, S. (2021) Medical Bankruptcy: Still Common Despite the Affordable Care Act. American Journal of Public Health, 111(3), pp. 431-433.
- Hoffmann, D. E., and Tarzian, A. J. (2001) The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain. Journal of Law, Medicine & Ethics, 29(1-2), pp. 13-27.
- Kaiser Family Foundation (2022) Hospital Adjusted Expenses per Inpatient Day. Kaiser Family Foundation.
- Kaufman, B. G., Thomas, S. R., Randolph, R. K., Perry, J. R., Thompson, K. W., Holmes, G. M., and Pink, G. H. (2020) The Rising Rate of Rural Hospital Closures. Journal of Rural Health, 36(1), pp. 35-43.
- Williams, D. R., and Mohammed, S. A. (2013) Racism and Health I: Pathways and Scientific Evidence. American Behavioral Scientist, 57(8), pp. 1152-1173.
