Jeff King went to the hospital for a procedure to fix an irregular heart rhythm. He expected a routine recovery. Instead, he received a bill that threatened to ruin him financially.
The hospital charged him $160,000 (£119,000). King, a 66-year-old former pastor from Lawrence, Kansas, did not have traditional health insurance provided by an employer. He was part of a cost-sharing alternative plan. Unfortunately, the plan stated it would not cover his treatment.
“It was pretty traumatic,” King said. He was shocked that a procedure lasting less than a day could have such a devastating financial impact.
King’s story is not unique. Recent data estimates that around 100 million people in the United States struggle to pay off medical and dental debt. That is roughly 40% of the population. The healthcare company King belonged to has stated that members must understand their membership guidelines and cost-sharing models. However, for patients like King, the reality of the bill is often a surprise.
High Spending, Low Results
The United States operates one of the most expensive healthcare systems on the planet. By 2026, spending on healthcare is projected to hit $5.9 trillion (£4.3 trillion). This figure comes from the Centers for Medicare and Medicaid Services.
Despite this massive investment, the results do not match the price tag. The US spends twice as much per person on healthcare compared to other wealthy nations of similar size. Yet, Americans have a lower life expectancy than people in those other countries.
Frustration Turns to Anger
As costs rise, patience is running out. The public mood has turned volatile. In December 2024, a gunman shot and killed Brian Thompson, the CEO of UnitedHealthCare, on a busy street in Manhattan.
Following the murder, some people on social media began to celebrate the suspect, Luigi Mangione. They viewed him as a folk hero striking back against a broken system. Supporters even gathered outside the New York courthouse during his hearings. They wore shirts reading “Free Luigi” and carried signs protesting the healthcare industry.
Recently, a judge dismissed a federal firearms murder count against Mangione. This charge could have carried the death penalty. One of Mangione’s lawyers, Karen Friedman Agnifilo, publicly thanked his supporters after the ruling. Mangione has pleaded not guilty to state and federal charges.
Political Disagreements on Reform
Both Republicans and Democrats agree that the system is too expensive and too complicated. However, they cannot agree on how to fix it.
President Donald Trump recently introduced his “Great Healthcare Plan.” His proposal involves sending money directly to citizens to help them pay for health insurance. He also pledged to remove “kickbacks” to middlemen.
“The Great Healthcare Plan… It’s great healthcare at a lower price,” Trump said. He promised accountability and transparency so that special interests cannot profit at the expense of patients.
Experts remain skeptical. They argue the plan lacks crucial details, such as how it will be funded or how much money people will actually receive. Critics also point out that recent cuts to government programs and the expiration of subsidies could make healthcare even harder to afford.
While profits for large, publicly traded health companies have tripled over the last two decades, legislative fixes have stalled. John McDonough, a professor at the Harvard TH Chan School of Public Health, noted that the US is the only major system that lets the free market run loose.
The Subsidy Crisis
For many Americans, the situation is getting worse right now. Stacy Cox runs a small photography business in Utah. She recently saw her insurance premiums threaten to jump from $500 a month to $2,100.
This dramatic increase happened because health insurance subsidies, which were expanded during the Covid pandemic, expired last year. These subsidies helped millions afford private insurance. Facing a quadrupled bill, Cox and her husband decided to drop their traditional insurance. They opted for a plan that covers emergencies only.
The decision has real consequences. Cox is at high risk for breast cancer. Without insurance, she cannot afford an MRI, so she plans to skip her mammograms. “I’m scared. What do we do?” she asked. “Right now, we’re just going to try to get by.”
Experts estimate that around four million people could lose insurance due to the end of these subsidies. For those relying on this help, costs could rise by an average of 114% annually.
A Patchwork System
Part of the problem is the complexity of the American system. It is a mix of Medicare, Medicaid, employer-sponsored insurance, veteran’s health, and the private marketplace.
“We have so many, each of them with their own set of rules, their own system, their own bureaucracy,” said Professor McDonough. He believes the system needs consolidation to reduce waste and confusion.
Without federal reform, some states are trying to help. They are banning medical debt from credit reports and providing their own subsidies. However, finding a nationwide consensus remains elusive.
Living with Debt
Mike Short, a 42-year-old graphic artist from Tennessee, knows the burden of medical debt well. In 2021, he was hospitalized with Covid-induced pneumonia. Even with insurance coverage, he was left with an $8,000 bill.
Now, Short is one of the many people affected by the end of federal subsidies. He has had to go without insurance entirely. Coming from a family with a history of diabetes, he worries constantly that a new medical issue could force him back into debt.
“I’m trying to keep myself fairly healthy, but things sometimes get out of your control,” Short said.
Charities Stepping In
Where the government and market fail, charities are trying to fill the gap. Eva Stahl is a senior executive at Undue Medical Debt, a nonprofit that buys and pays off medical debt for people.
Over the last decade, her organization has cleared about $25 billion in debt for 15 million people. This included Mike Short’s hospital bill. Stahl sees the anxiety this debt causes every day. She notes that people often skip meals or avoid seeking necessary care because they are afraid of the cost.
A Long Road to Relief
Jeff King eventually found a way out of his $160,000 nightmare. He did his own research and found that other hospitals charged far less for the same heart procedure. through persistent negotiation, he managed to get the bill lowered to $90,000.
He paid the hospital $500 a month, but the stress was overwhelming. His family eventually set up a crowdfunding page, raising about $25,000 to help cover the remaining balance.
When he finally paid off the debt, King said he felt a massive weight lift off his shoulders. But he knows others are not as lucky.
“Most bankruptcies are caused by medical bills,” King said. “It wrecks people’s lives at no fault of their own.”
