Let me say something that sounds ridiculous but is completely normal in the United States: your access to healthcare depends on your job. Not your health, not your needs, not your situation. Your job.
Lose your job, and you are not just losing income. You are losing your insurance, your medical care, your medications, and your ability to get care without going into debt. And somehow this is just accepted as the way things work.
This did not start as some brilliant system. It emerged during World War II, when wages were frozen, and employers began offering health insurance as a perk to attract workers. It was supposed to be temporary. Instead, it became the foundation of how millions of people access healthcare today.
Now we have a system where people stay in jobs they hate because they are scared to lose coverage. People delay care because they are between jobs. Every time you switch jobs, you are dealing with new plans, new deductibles, new rules, and half the time, you have no idea what is actually covered until a bill shows up.
And here is the part that really makes you pause. Other developed countries look at healthcare and housing as basic human rights. There are no preconditions. You do not have to be employed to deserve care. You do not have to earn the right to seek medical care. Everyone has the right to a roof over their head and access to healthcare. Meanwhile, in our part of the world, both can disappear the moment your paycheck does.
And let’s be honest about this phrase everyone loves to say: “I have good insurance.” What does that even mean anymore? High deductibles, constant prior authorizations, random denials, and networks that change without warning. That is not security. That is conditional access.
From where I sit in revenue cycle, I see the fallout every single day. Medical claims are denied because coverage lapsed for a week. Patients are blindsided because their doctor is now suddenly out of network. Bills are stacking up because someone changed jobs at the wrong time. None of this is rare. This happens every day.
So what is the solution? That is where it gets crazy. Because the people who could actually fix this, Congress, are the same people sitting on committees that regulate the insurance industry while taking millions in lobbying dollars from it. In 2023 alone, the healthcare sector spent $745 million lobbying Congress, more than any other industry in the entire country. These are not people who are motivated to dismantle a system that funds their campaigns.
Real change would require untangling healthcare from employment entirely. That means legislation. That means politicians are willing to bite the hand that feeds them. And that means voters who understand what is actually happening and show up angry enough to demand it.
Until then, the system stays exactly the way it is. Profitable for some. Unstable for everyone else.
If your ability to get medical care disappears the moment your job does, that is not a healthcare system. That is a hostage situation with a benefits package.
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