Natalie Davis is CEO and Co-Founder of United States of Care, an organization dedicated to making our health care system more equitable.

Seeing the public’s reaction to healthcare unfold over the last few years feels a bit predictable. The rise of the wellness industry, a growing but unfounded skepticism toward vaccines, the general suspicion and rage toward our healthcare institutions—these tell us a similar but unfortunate story that we hear in United States of Care’s work all the time. And with the recent tragic death of UnitedHealthcare CEO Brian Thompson, people’s sentiments about healthcare in this country are even more important to consider.

We’ve now talked with over 25,000 people mapping the human experience in healthcare, and we often hear that people feel like they just can’t figure out how to navigate the healthcare system. Many feel that they’re the only ones that feel this way. They’re alone, anxious about cost and wondering: “Is anyone else as confused as I am?”

As we’ve traveled across the country listening to people from all kinds of communities, we’ve uncovered some pretty sobering insights. People everywhere are struggling to afford healthcare, they’re being shuffled between different providers who aren’t talking to each other, and they’re left with unexplained charges and a general feeling that this system isn’t meant to make them healthy but to make others wealthy. From trying to avoid high out-of-pocket costs to sifting through confusing bill after bill, people often feel like they’re wandering the maze of the healthcare system on their own.

Bouncing Between Providers

I’ve heard from people time and again that they just want to be healthy, but our healthcare system doesn’t feel like it’s out to help them—it’s an obstacle to overcome. Some feel like it’s designed to make money off of them, keep them coming back for more and leave them confused and burdened with debt. Here’s an example: You’re experiencing jaw pain, so you go to your primary care provider. Your primary care provider says they can’t help you and refers you to an ear, nose and throat specialist. The ear, nose and throat specialist says this looks like a problem for a dentist. You visit your dentist, who says this looks like a problem for an ear, nose and throat specialist.

Back and forth, bouncing around between providers who have no clue what your other doctors are telling you—that’s the healthcare experience many people are having. In this situation, they may be left so frustrated with the process that enduring the jaw pain sounds better than figuring out which provider they should talk to. And on top of that, they’ve paid for care at each step of the process and still don’t have an answer. From our conversations, I’ve learned that this kind of story isn’t unique. As one person told us, healthcare is like a cafeteria line—you move from provider to provider, they scoop healthcare onto your tray, and then tell you to move along.

The Burden Of Cost

It’s no wonder that people distrust this system when they can’t even anticipate what they’re going to be stuck paying for. People seem to feel like the healthcare system puts profit over their health and that it looks to take as much from them as possible. They don’t always feel like they can depend on it, understand it or afford it, and they may be seeing the impact of hospital consolidation in their communities and on their health. As someone recently told us, “They get bigger, we get smaller.”

Healthcare is expensive—this isn’t a surprise. But what is surprising are the kinds of additional fees that get tacked onto patients’ bills for seemingly no reason at all. One of the fees they might see show up on their bill after a visit is the facility fee. These fees are charged because they receive care in a doctor’s office or clinic owned by a larger hospital or health system. There have even been instances where people were charged facility fees for meetings with a doctor on Zoom. Oftentimes, these fees aren’t covered by insurance, aren’t disclosed ahead of time and may exceed the actual cost of the care they were seeking.

As small hospitals and doctor’s offices everywhere have been gobbled up by massive corporations, these facility fees have found their way into mailboxes across the nation. At the same time, people have watched as some of these large companies have reportedly taken significant cost-saving measures (paywall), often aimed at growing profits, despite the potential impact on health.

What Healthcare Leaders Can Do

Healthcare leaders from across the industry are pushing new ideas that they think will solve the biggest issues in healthcare. Despite this, people may still feel like they aren’t being heard. They can feel that their challenges are being ignored, which can lead them to look for answers outside of the system.

It’s important that we don’t misread this sentiment, though. While people are clearly upset at the system, that doesn’t mean they want attacks on their healthcare coverage or the services it covers, including vaccines. Like I said, we’ve talked to over 25,000 people in all fifty states, and if skepticism about vaccines or fluoride was a key driving force for people’s dissatisfaction with healthcare, we’d have heard about it.

To restore trust, leaders in the healthcare space need to hear what people are saying and deliver the kind of targeted changes they want, like affordability and personalized care. We should continue taking steps toward building a patient-first healthcare system that treats patients as whole people—not a collection of problems with a provider for each one. Patient-first care (also known as value-based care) is an approach to paying for healthcare that prioritizes quality over quantity by tying patient health outcomes to payment. It incentivizes providers to partner with people in their health to fix the root cause of healthcare problems, as opposed to a fee-for-service system where people pay the same amount for services regardless of whether the care they received worked.

We should hear people when they say they’re struggling to afford healthcare and advocate for policy change that makes care more affordable—especially hospital care.

People just want to be healthy. But right now, I’ve found they feel like they’re stuck between their healthcare needs and our healthcare system. All of us, from policymakers to advocates and industry leaders, should take part in hearing what people are saying and delivering the change they need.

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