Every week, another headline. Fully insured Americans — some of them clearing six figures — putting off having kids. Delaying the purchase of a house. Skipping the doctor’s appointment they actually need.
Not the fringe. Not the uninsured. Everyday people.
Here’s what the numbers say. A West Health-Gallup survey found 37 million Americans have put off buying a home because of health care costs. Another 46 million delayed changing jobs. Nearly one in four insured adults skipped care they needed in the past year, and about half of households earning $48,000 to $180,000 have postponed a major life decision in the last four years for the same reason.
That’s not a coverage gap. That’s a system working exactly as designed.
We tell ourselves this is an unfortunate byproduct — rising costs, an aging population, and the price of modern medicine. That story lets everyone off the hook.
The medical-industrial complex is not just failing to serve people. It’s actually doing what it was designed to do: serving shareholders. Every deductible reset, every shift in premiums, every slight PBM change, and every prior authorization surprise bill are doing just what they were designed to do: putting profits on the bottom line of organizations, not serving the health of the community.
Structural problems don’t get solved by people who benefit from the structure.
They get solved by disruptors — the benefits advisors who’ve seen the real numbers behind a renewal, the doctors building direct-care practices, the self-funded employers who got tired of asking permission to take care of their own people. Individually, we’re noise. A rounding error the industry can absorb without noticing.
Let’s quit complaining. Let’s do something to change the structure so that having a good job and good insurance brings peace of mind to your employees, rather than big profits for the medical-industrial complex.
So here’s the question worth sitting with: are you working around the system, or are you willing to say — out loud, to the people who need to hear it — that the system itself is the problem?
Which one are you?
Source: West Health-Gallup survey via Axios (axios.com/2026/03/12/healthcare-costs-america-survey-sacrifices)
