DECEMBER 5, 2025 | OPINION | By Stecy Mwachia
Insurance companies are some of the biggest targets in American politics and social commentary in 2025, with very good reason. Millions in the country remain uninsured, dealing with conditions, ailments and injuries and taking on overwhelming debt. Many more remain insured and still unable to maintain the cost of their physical and mental health. As consumer advocate and lawyer Ralph Nader explained, “Health-care in the United States is a nearly three trillion dollar a year industry replete with excessive profits for many hospitals, medical supply companies, pharmaceutical companies, labs and health insurance vendors.”
What lies at the core of the divide between what this industry can provide American citizens and what the populace can afford? The answer lies in two intertwined structural failures: the wildly inflationary practices of healthcare providers and the intentional lack of transparency employed by insurers.
The rampant inflation of healthcare costs initiated at the provider level is the first fundamental issue driving this increasing gap in access, oftentimes through the opaque system of the hospital charge master. Hospitals dramatically inflate healthcare costs before the application of insurance, which makes insurance a necessary evil in the lives of us all. This is due to healthcare conglomerates demanding massive discounts on medical goods.
To bring profits up and costs down, hospitals charge an exorbitant amount for services and goods listed in their charge master, then discount the price of goods from that inflated cost to sell to the insurer. Hospitals across the country have skyrocketed their prices for these goods in the past 50 years, which ultimately trickles down into consumer medical premiums.
Nader continues, “In a news release, NNU revealed that fourteen hospitals in the United States are charging more than ten times their costs for treatment. Specifically, for every $100 one of these hospitals spends, the charge on the corresponding bill is nearly $1,200.” This practice of price gouging, cloaked in complex contracting, sets a dangerously high baseline for all medical costs.
Aggressive inflation of prices by providers is further amplified by the insurance industry’s attitude regarding human rights and patient well-being. The underlying disease is the industry’s systemic practice of prioritizing profit protection over human life, while the high cost of premiums and deductibles is the symptom. Insurance companies operate not merely as financial intermediaries, but as active manipulators of clarity.
The second pressing issue is the intentionally dense, technical language and jargon that insurance companies use. Maintaining obfuscation between the plain physical truth and the maze of language needed to address it is extremely profitable for hospitals and insurers alike. When policies are written in impenetrable prose, people are less likely to understand what is covered, how to appeal decisions or when they are being denied care.
That confusion keeps customers passive and prevents them from challenging a system built around protecting corporate risk rather than patient well-being. It also successfully hides the real harm, masking how routine it is for insurers to delay treatment, deny claims and push people into medical debt.
This phenomenon is exacerbated by language barriers. Adults who have limited English proficiency are more likely to report their physical health as “fair” or “poor” compared with adults who are English proficient (34% vs. 19%). Limited English proficiency refers to when patients speak a different language primarily and use limited English to communicate with their healthcare providers.
In the United States, where public education is failing, literacy rates sit at around 79%, leaving 21% of US adults functionally illiterate. These effects are not just because of a healthcare system not designed with non-English speakers in mind, but reflect an insurance system dedicated to using language to lock marginalized people out of the system. Blue Cross Blue Shield’s “Glossary of Insurance and Medical Terminology” presents readers with a total of 161 defined terms to become acquainted with.
When the language feels too complicated to fight, people internalize that powerlessness. The result is a healthcare system that treats patients like liabilities instead of human beings, with insurers relying on this linguistic barrier to obscure how structurally dehumanizing and exclusionary the system truly is.
The chasm between the capabilities of American healthcare and its affordability is not accidental. It is the result of deliberate systemic choices by those who have the capability to save lives but feel as though some aren’t deserving of the care required to preserve them. The crisis is fed by two mutually reinforcing mechanisms: hospitals setting artificially high prices to anchor negotiations and drive overall costs and insurance companies employing strategic deception to limit their payouts and keep policyholders from fighting back. Addressing this divide requires more than simple market adjustments; it demands regulatory changes that enforce price transparency at the provider level and mandate clear, accessible language in every consumer insurance policy.
Only by dismantling these twin pillars can the United States begin to achieve a healthcare system that truly serves its populace, not squeezes it out for every last penny.