It’s tempting to start a topic such as this by saying something sensational – like, “The American healthcare system is a giant scam!” I’m going to do that though, for two reasons.

One, because it’s unproductively dismissive; and two, because it may inadvertently give the impression that it’s a good idea not to have health insurance.

It is not a mistake that a procedure in America will cost several times how much it will cost pretty much everywhere else in the world. It’s not a mistake that the same drug will cost several times as much in America than it will in other countries. The word ‘mistake’ suggests that these realities weren’t made on purpose. Make no mistake, this is all by design.

The American health insurance business is designed to benefit someone; it’s just certainly not me, and probably not you. Let’s start with the big question first.


A common rationalization is that “We have the most expensive health care because we have the best healthcare.” It makes sense, right? Our hospitals are clean, our medicine is filled with all those unpronounceable chemicals, and we have access to cutting-edge medical science. Of course, all of that is going to cost a lot of money.

Sorry to burst your bubble, but not only can you get access to much of the same medical equipment and pharmacology various places around the world; but it’ll be considerably cheaper. I don’t mean a foreign knock-off, either.

Many Americans carry a toxic image of the state of healthcare around the world. Uneducated doctors working in huts, prescribing ground up leaves and river water. This couldn’t be further from the truth. The fact that medical tourism (the practice of going abroad for medical treatment) became a 3 billion dollar industry in India in 2015 (and has only grown since) is proof of that.

Let’s get back to the question at hand. If much of the industrialized world is using the same stuff, why are Americans paying so much more for it? The answer: Because we can, or perhaps more to the point, because we will. Doesn’t seem fair, does it?

Who Benefits?

Pretty much everyone but the patients. It’s a self-perpetuating cycle of passing around the dollar of the consumer. Drug companies and medical manufacturers will charge absurd prices. To meet those costs, hospitals and doctors have to charge absurd prices. Most citizens can’t actually pay those prices, leaving them at the mercy of insurance companies for help.

Does it take thousands of dollars to produce one dose of a particular medicine? No, and to their credit, they are usually upfront about that. What they are less transparent about is the actual reason for the upcharge. The usual line is something like “You aren’t just paying for the drug, you’re paying for the research and development of this and future drugs.” It’s not a terrible line, but it’s not the whole truth either. If they lower their prices to something more reasonable, obviously they get less money. Moreover, it will make ripples throughout the entire industry. Cheaper drugs, cheaper care, less need for insurance. The less need for insurance, the less an individual can pay for care, the less the care providers can pay for drugs. The patients come up, the industry potentially collapses.

Why Any of This Matters

Health insurance isn’t like other types of insurance. If you don’t have auto insurance, you can decide not to get your car fixed and just not drive. If you don’t have health insurance and you decide not to get a tumor removed, you could be in constant pain or die. The stakes are not the same and to treat them as if they are is ridiculous.

If things keep going the way they are going, the question won’t be can you afford medical tourism, but can you afford not doing it. Reform is a matter for the government, there’s very little we can do about it on a day to day level. There is an election coming up though. Find out where the candidates stand and vote your interests.