I recently came across a guest essay in the New York Times titled “UnitedHealth Group C.E.O.: The Health Care System Is Flawed. Let’s Fix It.” (original article, alternative non-paywall link).

With a title like that, I was excited. Surely, this was going to have some substance—especially coming from a publication like the NYT. But I was disappointed.

The article offered no real solutions, no clear plan, and no concrete actions from the author or UnitedHealth Group itself. Instead, it was packed with platitudes about increasing transparency, providing individualized care, and building partnerships. These are nice ideas, but they’re meaningless without specifics about how to make them happen.

It made me reflect on something I’ve always found odd about how Americans view public services. Firefighters, police officers, and public education are not built around maximizing profits, yet healthcare—something so intimately tied to life and death—is treated like a business. Why is a police commissioner’s salary capped at $300-500k, while insurance CEOs make $10 million or more? Should staying alive and healthy be considered a luxury?

The deeper issue here is something the article tiptoed around: the health insurance system is fundamentally built on profit incentives, and that often pits the goals of insurers against the needs of patients. Insurance companies make more money by collecting premiums, denying claims, and restricting care. As long as the system has significant rewards for that kind of behavior, it’s hard to imagine meaningful change.

To be fair, profit incentives have driven real innovation in parts of the healthcare industry. In pharmaceuticals and medical technology, for example, companies have developed groundbreaking treatments and devices because they were motivated by the potential for high returns. Even in healthcare delivery, innovations like telemedicine and urgent care models have improved access and convenience.

When it comes to health insurance, the profit motive seems to do more harm than good. The focus isn’t on improving outcomes but on managing risk and cutting costs—often at the expense of patients. This is why we see practices like claim denials, complex coverage terms, and surprise billing. They might help a company’s bottom line, but they don’t serve the people who rely on health insurance to stay healthy.

The system is flawed, but it won’t change until we address the core issue: health insurance companies are incentivized to prioritize profits over patients by denying claims and restricting care. While profit can drive innovation in some parts of healthcare, as long as the system rewards putting dollars over providing the most effective care, it will be corrupted against patients.