“We literally just want health care.”
This common refrain frequently appears in the comments section of social media posts, often after an update on the Trump administration’s spending, the president’s goal to build a giant triumphal arch in Washington, D.C. or the costly, unpopular United States-Israel war with Iran.
The statement captures an ugly truth of American life: While legislation has been proposed (many, many times) to address the country’s health needs, lawmakers choose to fund other priorities, like war or immigration enforcement.
The fact is, health insurance in the U.S. is expensive when compared to other developed nations ― yet health outcomes are no better here. And since health care coverage isn’t guaranteed (unlike in other countries with universal health care), many people are uninsured or underinsured, leading to tough realities like skipping preventive appointments or rationing medication to make it last longer. Not to mention the fact that navigating the insurance system is confusing at best and impossible at worst. Prior authorizations, procedure and medication denials and copay hiccups are regular occurrences for patients, despite the fact that they’re paying for coverage in the first place.
It’s common for patients to express their anger about all of this to their doctor, especially after seeing an expensive bill or learning that a medical request has been rejected. But doctors like Dr. Jennifer Lincoln, an OB-GYN and practicing OB hospitalist, told HuffPost they’re frustrated with the state of health care in this country, too.
“From 2010 to 2021, the percentage of Americans who lived within 30 minutes of obstetric care went from 90% to 60%,” said Lincoln, author of “The Birth Book: An OB-GYN’s Guide to Demystifying Labor and Delivery.”
“And yet we can’t address this, but we can somehow look at a ballroom or spend an estimated $2 billion a day in a war in Iran that Americans don’t want.”
Below, Lincoln and other doctors share what bothers them most about health insurance in the U.S.
Smaller medical facilities can’t afford to stay open.
Private practices can’t afford to stay open, and that’s in large part because of health insurance companies, according to Lincoln.
“The average one-practice location cannot stay afloat because the amount of paperwork and insurance pre-authorizations, reimbursement, the amount of people needed to do it — it doesn’t offset the cost and the time,” Lincoln said.
“And for them to be able to even purchase medical supplies or vaccines, they have no bargaining power with these [insurance] companies, so they end up paying higher prices, and they’re not going to get reimbursed to that price when the insurance company is cutting reimbursements,” she said.
This causes small practices to close, especially in rural areas, which leaves people without a nearby doctor. Most have to travel far to get necessary care, Lincoln said.
And the practices that don’t close may be bought by health insurance companies or venture capital firms.
“A lot of private practices are being bought out by these insurance companies, because insurance companies now are refusing to play ball at all and maybe they won’t even sign a contract with a private practice, or they won’t reimburse,” explained Dr. Lauren Hughes, a pediatrician, owner of Bloom Pediatrics in Kansas and a medical communicator on social media. “And then they’ll be like, ‘Well, you know what if you let me buy you, then you can be in-network.’”
These types of companies will give medical practices “a good buyout so that they can retire and move on, but then will usually run it so poorly and squeeze it so bad that they’ll make as much money as they can, and then they’ll close,” Lincoln added.
Why do insurance companies and venture capitalist firms even want to buy smaller doctors’ offices?
“They take the copay. They are controlling how you bill. They are controlling how many patients you see. They’re controlling how many providers are there. They are controlling the salary of those providers,” Hughes explained.
Insurance or venture capital companies also profit from reimbursements from patients with other health insurance companies, Hughes noted. “So, it makes them hella dollars.”
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Patients aren’t the only ones who become frustrated by health insurance companies.
The health insurance paperwork and bureaucracy takes away from valuable time with patients.
“A lot of the frustration that we have is on the back end, so obviously it’s not on the patient-facing end,” said Dr. Eric Burnett, an internal medicine doctor at an academic medical center in New York and a health communicator on social media.
“We can communicate when insurance denies coverage for a certain procedure or medication, but then all of that falls on us in the background to have to call the insurance companies, do peer-to-peers and all these prior authorizations,” he added.
Doctors, essentially, have to “sort of argue with them,” according to Burnett. “We’re saying that the patient needs this medication, or the clinical reasoning behind this procedure and that procedure, and it’s frustrating because that obviously takes away time from clinical care.”
There are a lot of bureaucratic steps for doctors as they deal with health insurance companies; many are forced to rationalize why a patient needs the treatments they’re recommending, he added.
“These insurance companies don’t know the patients at all. They’re not their doctors … so, it’s frustrating on the provider end to have to deal with that,” Burnett said. “And I 100% share the frustrations with my patients too because as frustrated as I am with it, it’s 100 times worse for them.”
The cost of care is unknown to many doctors.
“When I see a patient and there’s a relationship between the two of us, I’m taking a history, doing an exam, forming a diagnosis and a treatment plan. As the doctor, I have no idea what the cost to the patient is going to be, which I think can be hard for the patient,” said Dr. Bonnie Hodge, a dermatologist in Alabama.
“I could walk in one room and that patient’s care is going to be completely covered, and then I could walk in the next room for the exact same problem, and their insurance is going to deny the charge for that claim, and then they’re going to be responsible for an $800 bill,” Hodge added.
This is clearly upsetting for the patient who winds up with a large bill. “I think that’s where a lot of the patients are frustrated with doctors,” Hodge said.
Hodge isn’t sure of costs because she’s employed by a practice and doesn’t own her own doctor’s office.
“It’s nearly impossible now to afford to open up your own shop,” Hodge said, which is once again evidence that private practices are becoming harder and harder to operate.
“Because of that, I’m so far removed from the billing side of things that I have no idea what the visit is even charging, and then I don’t know what the insurance is actually going to pay,” Hodge said.
Patients are often shocked to see their final bill, “and I feel bad because I had no idea it was going to cost that because I don’t know what their insurance is going to cover,” she added.
Doctors say health insurance companies pit patients against doctors intentionally — to distract from what actually needs to change.
It’s common for patients to think the health insurance company and the doctor are in a relationship together, but “they’re just the third party to the care we’re providing,” Hodge said.
“So, it leads to a lot of frustration on the patient end that feels misplaced, because we, at the end of the day, most doctors, we just want to help you,” she said. “I wish I could get all these drugs covered for everybody, but I just can’t.”
Health insurance companies are good at pitting patients and doctors against each other, Hughes said ― and that’s by design.
“The way I explain it to people is your wait staff didn’t [cook your steak wrong], but you yell at them … the problem is who we have access to. They are not the ones that can really create change,” Hughes explained. “But if they keep us fighting between each other, then we can avoid calling out accountability where it actually matters — with insurance companies.”
“The more they can keep the infighting between [doctors and patients] and stay out of it, then the better it is for them and their bottom line,” Hughes added.
What can you do to advocate for better health insurance and health care in this country?
Changing the health care system in this country shouldn’t be on the patients, especially those dealing with diagnoses or crushing medical debt — and there is only so much patients can do.
“Unfortunately, the insurance companies are very powerful lobbies in Congress,” Burnett said. “And as long as money rules politics, it’s going to keep going that way.”
“That may seem like a defeatist attitude, but I think it should galvanize everyone, regardless of political affiliation, that this is not working for us, and we need to move to a more sustainable system that’s going to benefit all of us ― not just the very, very wealthy in this country,” Burnett added.
Voting for candidates who have your best interests in mind is a good first step.
“Your vote matters. We’re seeing the impact that people’s votes have right now in terms of what’s going on with health care, what’s going on with the budget cuts … how they’re negatively impacting society as a whole,” Burnett said.
Trump’s “Big Beautiful Bill Act” calls for almost $1 trillion in cuts to Medicaid.
“That is just a very real, stark reminder that elections have consequences, votes have consequences and they have power,” Burnett said. “Using your vote to exact the change that you want to see because that’s what we can do.”
It’s also helpful to call your elected officials and tell them your stories of health insurance denials or outrageous hospital bills, Lincoln said.
“It really does matter to call, to write letters, to send messages, because the stories they cannot ignore,” Lincoln said. “I don’t want people to think that, ‘Well, you just have to grin and bear it. The problem is so overwhelming.’”
You can also call your representatives and encourage them to support the Break Up Big Medicine bill introduced by Senator Josh Hawley (R-Mo.) and Senator Elizabeth Warren (D-Mass.).
“It’s to stop the vertical integration and monopoly that health care insurances have,” Hughes said.
Speaking out, whether to local elected officials or even your local news station, makes a difference. Without this kind of pressure, nothing will change.
“This system is working exactly how they want it to,” Hughes said. “Your health care system is not broken. It’s fixed by them.”
