America’s frustration with the health care industry

It may be a while before we officially know what motivated a gunman to murder UnitedHealthcare CEO Brian Thompson Dec. 4, 2024. Unofficially, however, social media has decided the shooting had everything to do with America’s frustration with the health care industry.

Since Thompson’s murder, thousands — if not millions — posting with the hashtag #DenyDefendDepose are supporting the belief that the killing was inspired by a broken health care system. If social media’s sentiment ends up being right about the shooting, it would indicate that long-standing health care frustration has taken a dangerous turn.

It’s not news that Americans are unhappy about the quality of health care they receive. A 2019 survey revealed that 43% of Americans were unsatisfied with health care. A similar survey conducted in 2024 produced higher numbers, showing that over half of patients either felt “severe” frustration or were “burned out” by frustration due to their experiences with health care.

What is news, however, is that health care frustration is severe enough to inspire the kind of violence that US prosecutors have labeled as a terrorist attack. Those wondering what types of conditions have led to that level of frustration should consider the following.

The high cost of health care

A 2023 Harris Poll found that over 70% of Americans feel health care fails to meet their needs and identified affordability as the most significant barrier to health care access. The second frustration on the list also had a financial theme: US health care is “too focused on profit.”

Historical data shows health care frustrations focused on rising costs are not misplaced. One recent study on out-of-pocket health care expenses placed the average amount in 1970, after being adjusted for inflation, at $677. By 2022, it has risen to $1,425 — a 110% increase.

Reducing costs would require addressing a wide variety of issues. High drug prices are a primary part of the problem. While investment in drug development alone results in high costs, consumers must also shoulder fees added by pharmacy benefit managers.

The fragmented nature of the system is another issue that drives up prices. The administrative complexity it breeds leads to excessive costs in billing, reimbursement, and revenue cycle management, all of which are typically passed on to patients.

The industry's common fee-for-service models are an overarching issue contributing to the high cost of health care. These models incentivize quantity over quality, which means patients are often subjected to unnecessary exams, tests, and procedures, driving up costs without necessarily providing better care outcomes.

The decline in health care accessibility

While the high cost of health care affects accessibility by discouraging patients from seeking the care they need, it’s not the only factor. Problems related to staffing shortages and insurance coverage also lock patients out of health care.

Recent studies point to a shortage of nearly 100,000 critical health care workers by 2028. The aging population in the US will likely only amplify the impact the shortage could have on accessibility. As the Silver Tsunami lands in the US, the health care system will be forced to deal with increased demand from a demographic suffering from worse health than previous generations.

Even those with coverage can sometimes face accessibility challenges due to the network restrictions imposed by insurance companies. Those needing specialized care, for instance, can find that the best options for doctors are not provider-approved. Mandatory protocols such as step therapies or prior authorizations can also lead to delayed or denied care.

The confusing complexity of insurance systems

The same Harris Poll that identified affordability as a top health care frustration also found that nearly 30% of Americans struggle to understand what is covered by their insurance policies. The system's complexity reportedly leads to confusion and frustration with understanding the extent of coverage, its cost, and the providers that policyholders are permitted to visit.

One step to fixing the system would be to provide a higher level of standardization. Another would be to shorten the list of players with whom patients must interact as they seek care. Currently, moving through the system can require engaging with health plans, PBMs, brokers, provider networks, MCOs, ACOs, clinically integrated networks, and more.

The lack of personalized care

It’s not unreasonable for patients to expect their doctors to have the time to assess their unique condition, explore their unique circumstances, and recommend a course of action that is unique to their situation. However, the current system doesn’t allow doctors to meet that expectation for personalized care.

Frustration with the treatment they’ve received from insurance companies has inspired many doctors to stop accepting insurance, which means those who remain available to policyholders face overwhelming workloads. Consequently, many appointments feel rushed, which leaves many patients feeling frustrated.

Even when patients receive personalized care from primary care providers, that care can be derailed when they are sent to specialists. Due to the fragmented system, a primary care diagnosis can lead to a recommendation for a specialist who is inaccessible because of insurance limitations. As a result, patients are again left frustrated in their quest for effective care.

The frustrations Americans feel about the US health care system clearly communicate that those responsible for running the system have lost their way. To get things back on track, the industry must start by addressing the high costs, low accessibility, lack of personalization, and complexity that are keeping Americans from getting the care they need.

Lindsay Dymowski Constantino is the President of Centennial Pharmacy Services, a leading medication-at-home pharmacy, and co-founder and LTC@Home Pharmacy Companies, emphasizing the provision of long-term care pharmacy services in the home setting. With over 15 years of experience in the pharmacy field and a strong entrepreneurial spirit, Lindsay has a deep understanding of what drives successful pharmacies beyond medication dispensing—focusing on supporting organizational goals toward better health outcomes through patient-centric care. She is passionate about the future of pharmacy in healthcare, has been featured in U.S. News & World Report, and actively contributes to the field through national conference presentations, media appearances, continuing education programs, and board memberships dedicated to advancing pharmacy practice.