In early 2024, a network of US primary care doctors conducted a nationwide survey of patient frustration. The survey revealed that over half of patients either felt “severe” frustration or were “burned out” by frustration stemming from their recent healthcare experiences.
The level of healthcare frustration Americans feel became very clear in the aftermath of the December 2024 killing of UnitedHealthcare CEO Brian Thompson, who was fatally shot by a gunman who authorities believe was motivated by frustration with the healthcare industry. In the aftermath of the shooting, expressions of anger inspired by the state of US healthcare skyrocketed on social media.
For those seeking to understand the healthcare frustration Americans feel — as well as those in the industry who desire to make changes for the better — the following are the key issues that must be addressed.
Rising costs
Rising costs are one of the top frustrations Americans have with healthcare. Studies on out-of-pocket healthcare expenses, for example, show that average per capita spending in 2022 stood at $1,425 per person. In 1970, the amount — adjusted for inflation — was $677.
To reduce costs, the industry needs to address a wide variety of issues. Administrative complexity is a top contributing factor. The current US system is fragmented, which creates excessive administrative overhead, particularly around billing, reimbursement, and revenue cycle management. To stay profitable, healthcare companies pass on those administrative expenses to patients.
The fee-for-service models that have become prevalent in the industry contribute to high patient costs by incentivizing the quantity of care over quality. They also result in unnecessary tests, procedures, and exams, driving up the cost of treatment without improving outcomes.
High drug prices are another part of the problem. In addition to the cost of drug development, patients must cover the costs added on by pharmacy benefit managers, which are often owned by the insurers who administer the patients’ healthcare plans.
A lack of transparency with healthcare costs contributes to each of these problems. Today’s systems limit the visibility patients and providers have regarding their care, leading to inflated costs.
Low accessibility
The number of patients in the US needing care is climbing while the number of healthcare professionals able to provide care is falling. This results in an accessibility problem that is adding to frustrations.
Accessibility problems are significant in rural and underserved areas. The shortage of healthcare professionals in those areas forces patients to travel to receive both basic and specialized care. Consequently, they face financial challenges related to the rising costs of care and travel, which can include transportation, meals, hotel stays, and more.
Network restrictions imposed by many insurance providers also add to accessibility issues. Rules related to prior authorization and step therapies can result in delayed or denied care. Limitations related to the choice of doctors can also frustrate accessibility for those needing specialized care or facing complex medical issues.
Complex insurance systems
Before insurance limitations come into play, patients can experience healthcare frustration from simply trying to navigate their plans. Plan holders must be able to decipher the significance of deductibles, copays, and coinsurance, each of which is often expressed in technical terms in fine print. In addition, plans change frequently, adding new rules and restrictions.
The current structure of the insurance industry is the key driver of complexity. It lacks standardization, involves a lot of bureaucracy, and a long list of players. Accessing care often means engaging with health plans, pharmacy benefit managers, brokers, provider networks, managed care organizations, accountable care organizations, clinically integrated networks, and more.
Lack of personalization
Patients expect — and typically require — personalized care. They want doctors to take the time to understand their conditions and the unique factors that may be contributing to them so they can get a personalized course of treatment. If they feel they are getting a “one-size-fits-all” prescription, they are justifiably frustrated.
However, the conditions that exist in the current healthcare system leave doctors little time for personalized care. The frustrating experiences doctors have with insurance reimbursements have led many of them to go out of network or stop accepting insurance altogether. Consequently, those who remain accessible to patients with insurance must rush through an overwhelming number of appointments.
To make matters worse, patients must wrestle with a fragmented system that often short-circuits the personalized care primary doctors prescribe. When a primary care provider sends a patient to a cardiac specialist due to high blood pressure, for example, the patient can often find insurance billing policies prevent him from getting the treatment he needs from a cardiac provider. When specialized care gets derailed this way, treatable conditions become dangerous health risks.
Alleviating Americans’ healthcare frustrations is not easy, but a roadmap to change exists. By making adjustments that address rising costs, low accessibility, complex insurance systems, and a lack of personalization, the industry can get healthcare back on track to achieving its primary goal of encouraging and maintaining the health of the American people.
