Healthcareisnt broken. Healthinsuranceis

Published: Thursday, January 15, 2026 at 11:00 am

Health Insurance System Needs Overhaul, Experts Say

The American healthcare system is not inherently flawed, but the health insurance model is failing patients, according to a recent analysis. Despite rising premium costs, patients are receiving less in return, facing restrictions on their choice of doctors, hospitals, and medications. This situation demands congressional action to reform the system and empower patients.

The core issue lies in the nature of health insurance, which functions more like a prepaid medical care system than true insurance. Insurers collect substantial monthly payments but then impose limitations on how patients access care. A Government Accountability Office report revealed that a significant portion of Obamacare plans fail to meet network adequacy standards, leaving patients unable to find in-network providers despite paying for coverage.

This contrasts sharply with auto and homeowners insurance, which primarily cover catastrophic events. These insurers do not dictate where drivers buy gas or which mechanics they use, nor do homeowners expect coverage for minor repairs. In contrast, health insurers involve themselves in nearly every healthcare transaction, extracting substantial profits while limiting patient and provider autonomy.

The current system incentivizes insurers to prioritize enrollment numbers, often receiving taxpayer-funded subsidies regardless of whether enrollees utilize their plans. This leads to practices like enrolling individuals without their knowledge and inflating diagnoses to secure higher payments. Medicare Advantage, which covers a majority of seniors, is particularly susceptible to these issues. Insurers attract enrollees with non-healthcare perks while narrowing provider networks, potentially leading to significant overpayments.

The solution, according to experts, lies in restoring consumer control. This includes expanding health savings accounts, allowing patients to use their own funds to make informed healthcare decisions without insurer interference. Curbing the influence of large insurers and devolving control to consumers and providers is essential to address rising premiums and protect family budgets.

BNN's Perspective: The issues highlighted in this analysis are concerning and require careful consideration. While the current system clearly has flaws, any reform efforts must balance the need for patient choice and affordability with the importance of ensuring access to quality care for all Americans. A measured approach that considers both consumer empowerment and the financial stability of the healthcare system is crucial.

Keywords: health insurance, healthcare, premiums, Obamacare, Medicare Advantage, insurers, patients, consumer control, health savings accounts, healthcare reform, network adequacy, subsidies, overpayments, healthcare costs, access to care

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