Picture this: You’re sitting in a courtroom, and the defendant in front of you is a major insurance company. The charge? Denying a life-saving claim that led to devastating consequences for someone’s health. The prosecutor stands up, looks toward the jury—a group of everyday people like you and me—and declares, “They prioritized profits over the lives of people.” Doesn’t that statement hit differently this morning, especially as you sip your coffee?
It sounds outrageous, doesn’t it? Or does it? What if insurance companies were actually held liable for the outcomes of their decisions? After all, when we visit a doctor, we expect accountability, expertise, and a commitment to our well-being. Why should insurance companies, which wield life-and-death power over critical care, be any different?
When physicians call the shots
Let’s take a trip down the rabbit hole of “what ifs.” What if the people who decided whether or not your claim would be approved weren’t just numbers-crunching office workers, but real doctors—experienced, compassionate clinicians? Imagine a board made up of physicians who have spent decades in patient care, not just reading policies but understanding the human side of medicine. Decisions wouldn’t be based purely on data or cost-cutting; they’d be centered on people and their health.
We already trust physicians to make split-second decisions in life-or-death situations, right? Why, then, shouldn’t we trust them to decide whether your cancer treatment gets covered? If doctors were the ones in charge, we might not see absurd situations where a sprained ankle requires 15 years of medical records just to get a claim approved.
Incentivizing healthier lives
Here’s another thought: What if your insurance policy actually rewarded you for making good choices for your health? Imagine this: You get a routine mammogram or go in for a check-up, and your insurance premium drops. You finally quit smoking or meet your weight-loss goal? Your deductible decreases. You stay on top of your mental health with regular check-ins? Maybe that’s another reason to save. The possibilities are endless. Not only would this approach save lives, but it could also reduce the overall costs to the health care system.
Preventive care works. The CDC reports that chronic conditions like diabetes, heart disease, and cancer account for 90 percent of the staggering $4.5 trillion the U.S. spends annually on health care. Imagine the savings if people got screened and treated earlier rather than waiting until it’s too late.
And picture how satisfying it would be if your insurance statement included a line that says, “Congrats, your healthy choices saved the system $12,430 this year!” That would definitely be a conversation starter at your next family gathering, don’t you think?
Breaking free from employer ties
What if, instead of fearing job loss as the potential end of your health insurance, we lived in a system where your health coverage wasn’t tied to your employer? In the U.S., 60 percent of people rely on employer-sponsored insurance. If you lose your job, you lose your health coverage. It’s an unfair blow when you’re already struggling.
A nation’s strength should be measured by more than just its GDP. It should be measured by the health of its citizens—mentally, physically, and emotionally. Why should a job loss or a career change mean the end of your access to critical care? It’s not just unfair; it’s inhumane.
Countries with universal health care systems, like Canada or the U.K., don’t tie health insurance to employment. Sure, there are frustrations with wait times, but rarely does anyone have to worry about bankruptcy from a hospital stay. I’ve lived in both systems, and trust me, there’s something deeply reassuring about not having to fight for basic care when you’re already dealing with health issues.
A brief history of health insurance chaos
The health insurance system we have today didn’t always look like this. It evolved out of necessity during World War II when companies began offering health benefits to attract workers during wage freezes. Over time, what was once seen as a bonus turned into a must-have, and now we’re tangled in a maze of bureaucracy that even Kafka might find overwhelming.
The Affordable Care Act (ACA) tried to bring some order to this mess, but we’re still far from a system that prioritizes health over profit. Just take a look at this: In 2023, U.S. insurance companies made a combined profit of $88 billion. Meanwhile, medical debt continues to be the leading cause of bankruptcy in this country. Something doesn’t add up—and it’s not just the hospital bill for a single aspirin costing $30.
A nation’s health is its wealth
As a physician and a coach, I see firsthand the toll this system takes on people’s health and happiness. Imagine a world where advocacy wasn’t just a buzzword but a movement. Where health care systems were designed to lift people up, not drown them in red tape.
I’m hopeful that someday, we’ll look back at this era of insurance-driven chaos and laugh—hopefully, from a place of health and well-being. But for now, it’s up to all of us to keep pushing for change. We need to use our voices and demand a health care system that’s actually designed to help people.
If you’re reading this and feel fired up, good. Health care advocacy is no longer a “nice-to-have” thing—it’s essential. Because at the end of the day, the true strength of any nation lies in the health of its citizens.
As for me, I’m optimistic. I truly believe change is possible. As the late U.S. Senator John Lewis said, “Never, ever be afraid to make some noise and get in good trouble, necessary trouble.” It’s time we made that noise.
Tomi Mitchell is a board-certified family physician and certified health and wellness coach with extensive experience in clinical practice and holistic well-being. She is also an acclaimed international keynote speaker and a passionate advocate for mental health and physician well-being. She leverages over a decade of private practice experience to drive meaningful change.
Dr. Mitchell is the founder of Holistic Wellness Strategies, where she empowers individuals through comprehensive, evidence-based approaches to well-being. Her career is dedicated to transforming lives by addressing personal challenges and enhancing relationships with practical, holistic strategies.
Connect with her on Facebook, Instagram, and LinkedIn, and book a discovery call to explore how she can support your wellness journey. For those interested in purchasing her book, please click here for the payment link. Check out her YouTube channel for more insights and valuable content on mental health and well-being.
