Op-Ed: United Health Probe Reveals Healthcare System's Deep Flaws

The U.S. Healthcare Sector Faces Increased Scrutiny

The U.S. government is intensifying its efforts to address unethical practices within the healthcare sector, with a particular focus on major players like United Health. This healthcare giant, currently the largest company in the industry, is under investigation by the Department of Justice for alleged Medicare fraud, potential antitrust violations, and a separate civil probe. These investigations highlight growing concerns about the lack of transparency and fairness in an industry that has long been criticized for prioritizing profits over patient well-being.

Patients are not the only ones raising alarms about the high costs and lack of price clarity in healthcare. Reports suggest that many Americans are increasingly frustrated with the system, which often forces them into financial hardship due to unexpected medical bills. Experts argue that stronger oversight, improved transparency, and stricter consequences for fraudulent billing could lead to a more patient-centered healthcare system.

United Health is not alone in facing scrutiny. Other top companies in the sector are also under similar investigations. Recently, the Department of Justice filed a complaint against Aetna Inc., Elevance Health Inc., and Humana Inc., alleging that they paid hundreds of millions of dollars in illegal kickbacks to insurance brokers in exchange for enrollments in their Medicare Advantage plans. Additionally, Aetna and Humana are accused of discriminatory practices against patients with disabilities for financial gain.

Market Dominance and Patient Concerns

To understand the scale of influence these companies hold, it’s important to look at their market presence. United Health is the largest insurance company in the U.S. by market capitalization, valued at nearly $275 billion. It controls approximately 15% of the U.S. health insurance market and serves over 29 million Americans, according to a 2024 report from the American Medical Association. Competitors such as Elevance Health and CVS Health each control about 12% of the market.

While their size may not be inherently problematic, the way these companies operate has raised serious concerns. In 2024, United Healthcare settled a case involving a severely ill student from Penn State University who suffered from ulcerative colitis, a condition requiring annual medical treatment costing around $2 million. The student claimed that United Healthcare denied coverage for essential medications prescribed by his doctors, resulting in a bill exceeding $800,000. ProPublica's investigation revealed that the company had hidden the student’s medical records to reject his insurance claims.

The Problem of Price Transparency

A major issue in the healthcare system is the lack of transparency regarding medical costs. Patients often find themselves surprised by large bills after receiving treatment, as hospitals frequently fail to disclose prices upfront. Nearly 80% of U.S. hospitals do not post the costs of essential procedures on their websites, despite legal requirements to do so. This lack of information can lead patients to delay or avoid necessary care out of fear of financial burden.

Consumers are demanding change. A recent poll by PatientsRightsAdvocate.org found that almost all Americans believe they “deserve to know the price of their healthcare before they receive it.” A staggering 94% agree that lower healthcare prices would make a significant difference for families struggling to afford basic needs. Additionally, 85% believe that price transparency will help reduce healthcare costs by making it harder for hospitals and insurers to overcharge patients.

Federal Action and the Path Forward

Federal officials have taken steps to address these issues. President Trump’s February 2025 executive order aims to enforce federal healthcare price transparency laws. This initiative builds on rules that took effect in 2021, requiring hospitals to publish “machine-readable files” containing negotiated rates for every service they offer. Implementing these regulations is crucial for providing relief to patients trapped in a broken system.

In the meantime, organizations like Solidarity HealthShare continue to work toward ensuring that patients receive affordable, ethical care. The era of surprise medical bills and excessive charges must come to an end. With proper reforms, healthcare should be accessible and fair for everyone, as it was always intended to be.