How the booming US healthcare economy is penalising patients

{"text":[[{"start":7.75,"text":"Jason King Jones paid less than $100 to have a cancerous tumour removed in 2022. Four years later and facing another cancer scare, Jones has nearly $1,000 in healthcare bills for similar services."}],[{"start":23.7,"text":"Jones has spent hours on the phone fighting to get money reimbursed from health services. “The quality of health insurance coverage has declined,” said the 50-year-old from Center Valley, Pennsylvania. “It feels like more burden is being put on the individual.”"}],[{"start":38.75,"text":"Jones’ mushrooming medical costs highlight a crisis in the US healthcare sector. As an ageing population puts pressure on the system, higher demand for services has pushed up labour costs and encouraged hospital consolidation that has sparked disputes with insurance companies. "}],[{"start":55.65,"text":"The result has left America with a health economy that is at war with itself — and patients footing the bill. "}],[{"start":61.6,"text":"“It is a good system, but it has its flaws,” said Richard Anderson, chief executive of St Luke’s University Health Network. St Luke’s serves much of Bethlehem and the surrounding Lehigh Valley — an electoral battleground close to Center Valley where the FT has a years-long reporting project."}],[{"start":null,"text":"

"}],[{"start":80.05,"text":"The pain has worsened as Donald Trump’s tariffs and the war in Iran drive up inflation in the wider US economy. "}],[{"start":87.7,"text":"The Trump administration’s flagship tax and spending bill also made it more difficult for elderly, low-income and disabled people to qualify for government-subsidised healthcare. The Congressional Budget Office estimated in June last year that the legislation would increase the number of Americans without health insurance by 7.8mn in 2034, adding more financial strain to hospitals. "}],[{"start":112.1,"text":"At the same time, people covered under former president Barack Obama’s landmark Affordable Care Act, which offered cheaper health insurance, are facing a 58 per cent increase on average this year, partly because Congress let enhanced tax credits on certain plans expire last year, according to non-profit KFF. "}],[{"start":130,"text":"These increased costs are hitting voters ahead of November’s crucial midterm elections, with nearly three-quarters of those polled saying they were very or somewhat concerned about health insurance costs rising this year, according to a recent Axios/Ipsos poll. "}],[{"start":146.25,"text":"In Bethlehem, the healthcare industry and its rising costs are a major part of the local economy. Hospitals in the greater Lehigh Valley have replaced steel as the largest driver of jobs, and new healthcare buildings are going up all over the region."}],[{"start":161.45,"text":"Nationally, healthcare is a boon to the US economy. As one of the country’s fastest-growing sectors, healthcare jobs comprise the largest portion of the nation’s workforce."}],[{"start":172.45,"text":"But its growth has worsened patients’ anxieties as they watch the sector balloon alongside their bills. In the Lehigh Valley, hospital construction sites dot streets as St Luke’s University and Lehigh Valley Health Network, the region’s largest employers, embark on multimillion-dollar expansion projects. "}],[{"start":191.89999999999998,"text":"“They are just popping up all over the place,” said Yusuf Dahl, 46, chief executive of a non-profit, who is paying more this year for his employees’ healthcare as premiums rise. "}],[{"start":202.64999999999998,"text":"“One thing you will often hear people say is ‘well, if [hospitals] didn’t build so many damn facilities, would the price not be as much?’”"}],[{"start":211.24999999999997,"text":"In addition to inflation and higher labour costs, demand for procedures that dipped during the Covid-19 pandemic has roared back. And insurers say they need more money from hospitals and patients to cover the wave of Americans on speciality drugs from complicated gene therapies to weight-loss jabs."}],[{"start":null,"text":""}],[{"start":230.09999999999997,"text":"Provider networks are increasingly merging to share costs. In the past 10 years, St Luke’s has acquired opioid treatment centres, rural hospitals and expanded into New Jersey."}],[{"start":240.79999999999995,"text":"Anderson said that consolidation is essential. “We have rescued — that’s the word, rescued — seven small community hospitals from insolvency,” he said."}],[{"start":251.49999999999994,"text":"LVHN in 2024 also merged with Jefferson Health, a Philadelphia-area hospital chain. "}],[{"start":259.09999999999997,"text":"But consolidation is no silver bullet for managing costs. Margins are already thin and the majority of US hospitals are not-for-profit. So they have demanded that insurers pay more per procedure. Insurers say this is unfair because consolidation has given hospitals more leverage in cost-sharing negotiations. "}],[{"start":277.54999999999995,"text":"“For many not-for-profit hospitals, revenue growth and multibillion-dollar investment portfolios leave them better positioned than [their] operating margins suggest,” UnitedHealth chief executive Stephen Hemsley said in January at a hearing in Washington. "}],[{"start":292.19999999999993,"text":"Healthcare providers in turn blame health insurance companies. Anderson called insurers the sector’s “biggest band of thieves”. "}],[{"start":300.69999999999993,"text":"“We treat anyone regardless of their ability to pay,” he told the FT. “Their job is to make money for their stockholders.”"}],[{"start":309.3499999999999,"text":"Hospitals and health insurance companies are frequently at odds over the cost of patients’ care. Hospitals want to recoup dollars from insurance companies to cover emergency room visits, surgeries and other patient care. Insurance companies want to minimise payments and increase their profits. "}],[{"start":325.3999999999999,"text":"They negotiate the cost-sharing arrangements in an opaque process that leaves patients on the sidelines. And when they cannot agree, as is increasingly happening, it can lead to contract disputes that disrupt patient care. "}],[{"start":337.99999999999994,"text":"Earlier this year, LVHN cut ties with healthcare giant UnitedHealth over one such fight. UnitedHealth alleged LVHN tried to increase prices paid by the insurer by more than 20 per cent in one year. LVHN said UnitedHealth violated a contract clause determining how much money is paid for patients."}],[{"start":null,"text":""}],[{"start":361.59999999999997,"text":"The break-up between the hospital and insurer meant local patients had to part ways with doctors they have seen for decades and find new providers, said Melissa Hakim, a doctor turned patient advocate. “[It’s] really a problem,” she said."}],[{"start":376.09999999999997,"text":"Rick Sams is one patient affected by the dispute. With his doctor no longer covered by UnitedHealth, he has cancelled his annual endoscopy appointment twice this year and has no idea when he’ll be able to get the test needed to get treatment for his acid reflux. "}],[{"start":390.84999999999997,"text":"“Do I have to start over again and try to find another primary physician?” Sams asked. “We were holding out hope that they could reach an agreement.”"}],[{"start":398.9,"text":"As hospitals and insurance companies point fingers at each other against the backdrop of unrelenting price rises, patients can suffer. "}],[{"start":407.09999999999997,"text":"“It’s become more business-oriented and it’s really kind of the insurance making a lot of decisions. I mean, 15 years ago, there really would have been not a lot [of] need for a patient advocate,” Hakim said. "}],[{"start":419.15,"text":"“Our healthcare industry really profits when people are sick or they need medication . . . you’re making money from people being ill.”"}],[{"start":433.35,"text":""}]],"url":"https://audio.ftcn.net.cn/album/a_1791219551_7440.mp3"}