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By Joshua Resnikoff
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Americans can choose what they watch, what they eat, where they shop, and how they spend their money. Yet when it comes to their own health, they are expected to hand over thousands of dollars and accept whatever care the system makes available.
This is one of the most expensive contradictions in modern American life, and it is time to challenge it.
Consider the financial arrangement facing an ordinary American family. According to KFF’s 2025 Employer Health Benefits Survey, workers contribute an average of $6,850 annually toward employer-sponsored family health insurance.
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Those with a general annual deductible face an average individual deductible of another $1,886. That is a substantial financial commitment before an illness, an accident, or an unexpected diagnosis even enters the picture.
Think about what that money represents: A mother deciding whether her child’s symptoms warrant another specialist appointment. A father trying to accommodate his daughter’s medical expenses alongside a mortgage. Grandparents weigh the cost of treatment against the savings they have spent decades building.
These are families paying into a system that can still leave them wondering whether they can afford to use it.
Consumers Without Choice Are Powerless
I find the arrangement almost impossible to defend. In healthcare, the premium is your admission fee, the deductible is another bill at the door, and the actual cost of treatment can still come as a surprise. How did an industry responsible for our most fundamental needs become so detached from the people financing it?
The problem is bigger than rising costs. It is the absence of meaningful consumer power.
Healthcare has been packaged into an enormous, largely inflexible arrangement in which individuals pay for coverage determined by employers, insurers, and institutional agreements. The money comes out of their paychecks, yet they have limited influence over where it goes or which services best serve their families.
Look at what has happened elsewhere. Streaming services dismantled the cable bundle because people wanted to pay for the content they actually watched. Amazon helped reshape expectations around convenience and access.
Consumers have learned that their money gives them a voice, and companies that ignore that voice eventually lose business. Healthcare has somehow escaped this expectation, despite being the one industry in which purchasing decisions can have the greatest consequences.
I recently experienced a particularly revealing example. After cutting my hand on broken glass, I went to my local hospital for stitches. Before treatment, I was offered a 10 percent discount if I paid the outpatient bill up front. The hospital was willing to charge me less for immediate payment, even though I had insurance.
Think about that. A patient with coverage could secure a better price by paying directly, without even putting the expense toward the insurance deductible.
If the economics of healthcare change when the patient pays directly, why are patients so often denied the opportunity to make that choice?
More Proactive Alternatives
The alternatives are already taking shape. Direct primary care, telemedicine, at-home blood testing, digital health monitoring, and online nutrition services are giving people new ways to manage their well-being.
A family can choose a service to monitor physical activity or access specialist advice before a condition becomes urgent. This is healthcare as an ongoing household decision, not simply an emergency transaction.
A healthcare system that gives individuals greater control over their spending could change how families approach their well-being.
Preventive services would become easier to prioritize, and people could direct their resources toward the care that makes the greatest difference to their lives.
Such a shift could gradually move healthcare toward a more proactive model, where managing one’s health becomes part of everyday life.
The cost of failing to make that transition, however, is already visible. Families continue to absorb rising premiums and additional medical expenses, while some delay routine appointments until their conditions become harder and more expensive to treat.
Eventually, the burden falls on emergency services, household finances, and the patients who have the least room to absorb another bill.
The Real Price We Are All Paying
The OECD’s 2025 Health at a Glance report puts America’s performance into perspective. U.S. life expectancy stands at 78.4 years, 2.7 years below the OECD average. Preventable mortality is also higher, at 217 deaths per 100,000 people compared with the OECD average of 145.
The country spends heavily on healthcare, yet the outcomes demand a harder examination of what that expenditure actually delivers.
None of this means health insurance should disappear. I still want catastrophic coverage if I suffer a heart attack or need emergency surgery.
I have car insurance because I cannot reasonably absorb the cost of a serious accident. I do not expect it to pay for my oil changes or replacement tires.
The same principle should apply to healthcare. Insurance must protect families from devastating medical expenses, while individuals should have greater freedom to choose and pay for the everyday services that help them stay healthy.
The industry will not surrender its existing business model easily. Too much money and too many entrenched interests depend on the current arrangement. But consumer behavior is already changing, and the organizations that recognize it will have an advantage.
The Challenges We All Face
My challenge to patients is to stop treating your healthcare coverage as the entirety of your healthcare.
Examine the services available to you, ask what they cost, investigate preventive options, and demand to know where your money goes.
My challenge to policymakers and healthcare executives is even more direct. Build a system in which patients can exercise real purchasing power, where providers must compete for their trust and insurance protects against financial catastrophe without dictating every routine healthcare decision.
Healthcare is too important to remain an industry in which the people paying the bills have so little say. The power to change that begins with recognizing a basic principle.
Patients are not passive recipients of a service. They are the people the entire system exists to serve.
Joshua Resnikoff is a biomedical engineer and founder of Sunstone Health, an AI-powered platform intended to connect patients with genetic care. All opinions are the author’s own.
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