Op-ed views and opinions expressed are solely those of the author.

My first job after graduating from college was as a medical claims examiner for a health insurance company. I was one of the “evil people” who people would mail their insurance claims and it was my job to determine whether or not the claims were paid or denied. In those days health insurance was much more affordable and most people had health insurance through their employers. These were the days of $100 deductibles, preexisting conditions and affordable premiums. They weren’t like the days of $5.00 copays that my parents paid when I was a kid in the 1960s, but they were definitely not like the cost of medical expenses in today’s American economy.

It is well documented that in the 1960’s the cost of healthcare rose dramatically as more Americans became insured and demand for medical services increased. Government programs like Medicare and Medicaid caused inevitable price increases by providers. In 1960, national health expenditures totaled $27.2 billion, which was 5% of GDP. In 2020, national health expenditures totaled $4.1 trillion, which is 19.7% of GDP according to the Centers for Medicare and Medicaid Services.

After spending a year working as a medical claims examiner, I opted to become a teacher and left the insurance industry. I also opened a retail business, and at that time (1986) premiums for small businesses were quite affordable, so I left my job as a teacher and ran my business for 19 years. As time passed, the premiums became outrageously expensive. This became a major reason why I had to close the doors of my business. Since I had no job, I opted for private insurance and was paying approximately $1200 per month in 2008.

At this time, I had my first kidney stone, which hit me in the middle of the night and I went to St. Joseph’s Hospital Emergency Room in Tampa. I had a CT scan done and it confirmed that it was a kidney stone. I was at the hospital for approximately 2 hours, given multiple prescriptions and sent home. Of course, I was never told how much this would cost. Four months later, I received a bill for over $7,000! I had to pay $4,000 out of pocket because of my $3,000 deductible. This convinced me that I needed to do something because if I had any kind of medical issue in the future, my life savings would be gone. I was working with an SAT company and visited China for six weeks. Eventually, I opted to move to China and resume my teaching career there. Unlike in the US, my age and experience were revered in China and I didn’t have to deal with woke administrators who apparently had issues with my age and the color of my skin. In China, I have won awards for being an excellent teacher whereas in the US, I couldn’t even get an interview (which is another story).

In China, ironically, I had a similar kidney stone episode. It was also in the middle of the night and I ended up in a Chinese ER. However, the cost was quite different. I was given medicine, charged 300 RMB, which is approximately $41 and the stone passed within a few hours.

This isn’t the only issue of dramatic differences that I experienced. In America, I had purchased a Ventolin inhaler for asthma, and the cost was over $200, and I needed to see a doctor to get the prescription. In China, I purchased a Ventolin inhaler, over the counter, for 25 RMB, which is approximately $3.50.

I have had 3 surgeries in China and paid a fraction of what I would have paid had these surgeries taken place in the US. Statistics show that U.S. hospital costs are 60% higher than in other countries. Various studies show that administrative costs make up about 15%-25% of US healthcare costs, which is double the administrative costs in Canada.

Given these facts, it is understandable why so many people are upset with the American healthcare system. For-profit insurance companies have taken over people’s lives, which is why there is such a backlash against companies like United Healthcare who have been reported to deny one-third of claims submitted to them. When people have the unenviable position of being forced to choose death or bankruptcy, resentment for the system is a natural and reasonable response.

Recently, the execution of United Healthcare CEO by Luigi Mangione has created an outpouring of support for this deranged young man and many people view him as a hero. Of course, people are frustrated at the system; however, this does not justify anyone murdering someone for doing his job, which is to provide his company with the most profits that they can accumulate. Imagine being this CEO’s wife or children who have to endure the loss of their father and husband and seeing people celebrate the actions of his murderer.

There are two ways for a company to earn profits: 1) increase sales 2) cut expenses or a combination of both. As time has passed, insurance companies have raised deductibles, limited procedures and eliminated things like the carryover provision (this was a provision that allowed medical expenses that were incurred in the 4th quarter, which were applied to the deductible to “carry over” and be applied to the following year’s deductible) Cost cutting measures increase their profits at the literal expense of their customers. The immense frustration of having to fight with an insurance company that has denied a claim and the expense of legal fees to fight with them in court is a David and Goliath situation, and unlike in the Bible, David always loses.

The government has attempted to put Band-Aids on these problems through a variety of measures that included: the HMO Act of 1973 and the 1986 Emergency Medical Treatment and Labor Act. However, prices still rose and new issues were created.

Most notably, the Affordable Care Act (Obamacare) was an attempt to lower costs, but instead of lowering costs, it mandated people to have health insurance, which was a windfall for insurance companies. It eliminated preexisting conditions as a reason for denying claims, however, this increased the cost of covering individuals and this cost was passed down to customers who saw their premiums rise dramatically.

The average American is being buried by a combination of greedy insurance companies as well as greedy providers and there is no end in sight, which is why many people see Luigi Mangione as a modern-day Robin Hood and view deceased CEO, Brian Thompson, as the Sheriff of Nottingham. However, the problem is far more complex, and until it is addressed more people will suffer due to an industry that is allowed to maximize its profits at the expense of those who need medical care.

Members of Congress are either in the back pockets of lobbyists for the medical and insurance communities, and why should they care? They have great insurance policies and need not worry that the fortunes that they have amassed will be put in jeopardy by a medical incident. The question that few seem to answer responsibly is this: Why are the costs of medicine, hospitalization and all medical services so much more expensive in America than anywhere else, and why isn’t anything being done to protect consumers from this kind of extortion that puts consumers between a rock and a hard place?

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Michael Matteo

Michael Matteo is an educator, produced playwright and screenwriter. He has written or co-written 4 books including one of the first jokebooks to make fun of political correctness.He owned a business for 19 years, and has been teaching for over 30 years.Currently he lives and works as head of the humanities department at private, international school in Chengdu, China.

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