Healthcare In An Unhealthy System

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A Necrotic-For-Profit Heathcare System

There’s a certain kind of American story that starts in the ER with chest pains and ends up in your Facebook feed from GoFundMe.

That’s the #1 priority; affording care. Not the diagnosis. Not the treatment plan. A fundraiser. You’re not just “sick,” you’re also “launching a campaign.” You don’t get discharged from the hospital so much as into a surprise dungeon where the final boss is an accounts receivable department in another time zone.

That’s the first tell that something is deeply off: in theory, we live in the wealthiest empire in human history; in practice, we pass the hat so our friends don’t die.

And the wild part? That’s not a bug. That’s the business model.

Start with the basic numbers, because they’re the part the industry is actually proud of.

Per person, the U.S. spends over $12,500 a year on healthcare—more than double the average of other wealthy countries, and far above the next big spender. Roughly 16–17% of our entire GDP is poured into “health,” compared to about 9% in peer nations.

What do we get in return for this grotesque cover charge?

We get a life expectancy that lags several years behind other rich countries. Americans clock in around the high-70s, while comparable countries hit the low-80s. We pay Mercedes-money for a ’98 Corolla with a check-engine light that never turns off.

This is what it looks like when “healthcare” is built not around health, or care, but around revenue:

Everything else—the warm slogans, the glossy “patient stories,” the posters about compassion—is set dressing for the extraction process.

And because capitalism never leaves money on the table, there’s a whole second layer bolted onto this mess: “wellness.”

If the formal healthcare system is a casino, the wellness industry is the g(r)ift shop on the way out. You still lose most of your savings, but at least you walk away with a forty dollar stress-relief candle (it’s got essential oils in it I think) and a year-long subscription to an app that reminds you to breathe via push notification.

We’ve built an entire parallel universe where:

The through-line is simple: your flavor of suffering is nothing more than a lead-segmenting filter.

Instead of asking “Why are so many people anxious, exhausted, and sick in the richest country on earth?” we get nothing more than mixed messages; we get told to practice mindfulness inside the blender. Do some deep breathing as you juggle three part-time jobs, no paid sick leave, and a deductible that’s bigger than your savings.

The message is never “You are being systematically immiserated,” it’s “Have you tried journaling?”

The U.S. has managed to invent a special kind of hell where you can have insurance, use it correctly, and still get buried in medical debt.

By one recent estimate, people in the U.S. owe hundreds of billions of dollars in medical debt. Tens of millions of adults carry some form of it; millions owe more than $1,000, and a smaller but very real chunk owe more than $10,000. That’s not fringe. That’s a mass-market product line.

We’ve normalized:

You know things are upside down when nonprofits whose whole mission is buying medical debt for pennies and canceling it can wipe out billions of dollars and the system barely notices. Some states and city governments have now started partnering with these groups and erasing medical debt at scale, because hospitals are willing to sell those debts for next to nothing.

Think about that. The same bill that can ruin your credit score and keep you up at night is, on the back end, just cheap paper in somebody’s portfolio.

If you designed a system from scratch to prioritize human well-being, it would not feature “terrorizing people over debts you literally don’t value” as a core mechanic.

Follow the incentives and the whole thing stops being mysterious.

Hospitals get reimbursed more for certain procedures and codes, so you get more of those. Insurers make money by charging premiums and not paying claims, so you get denial games, prior authorizations, and labyrinthine provider networks where “in-network” means “we’ll cover half if the moon is in retrograde.”

There’s a reason your doctor is staring at a screen half the visit: the system doesn’t pay them to care about you; it pays them to generate billable entries.

We talk about “burnout” as if clinicians just need more yoga. But a big part of that burnout is being forced to practice medicine in a system that structurally treats the patient like a monetizable object: a set of codes, a risk score, a revenue opportunity.

Even doctors are now getting toolkits on how to help patients navigate medical debt, because the problem is so massive it’s walked straight into the exam room and sat down on the table. That’s how you know the grift has gone too far: the people inside the machine are burning out on the cruelty.

Because Americans are allergic to blaming capitalism for anything, we’ve turned personal responsibility into a sacrament.

Got type 2 diabetes? You must have failed a vibes-based kale quota. Struggling with chronic pain? Maybe your mindset isn’t positive enough. Can’t afford a $5,000 deductible? Budget better, poors.

We’ve engineered an environment where:

Then we slap an individual health app on top and ask why everyone’s metrics are still red.

This is the heart of the grift: turning systemic harm into personal failure and then selling the cure back to you as a lifestyle upgrade.

You’re not exhausted because your boss owns your time; you’re exhausted because you don’t have the right morning routine. You don’t have chronic back pain from underpaid labor and zero ergonomic anything; you have “poor posture” and need a $300 smart device that vibrates when you slouch.

The system injures, then bills you for rehab. An actually healthy population is, from their perspective, a threat to shareholder value.

Fewer chronic illnesses mean fewer prescriptions. Less financial precarity means less tolerance for garbage jobs and garbage insurance options. A robust public system would undercut a whole class of parasitic middlemen whose only contribution to the ecosystem is generating invoices.

Of course the machine is optimized for ongoing sickness. That’s services the goal they all have in mind: repeat business.

Just to prove this isn’t some cursed law of nature, look at literally any other wealthy country.

Most of them spend about half as much per person on healthcare as we do and get longer lives, less financial trauma, and far less time spent arguing with insurance adjusters instead of talking to doctors. They manage this with boring, unsexy policies like:

Are those systems perfect? No. But you’re significantly less likely to lose your house over an ambulance ride, which feels like a low bar for a supposedly civilized society.

The point isn’t “democratic socialism is a magical cure-all,” it’s that it is technologically, logistically, and economically possible to organize healthcare around people instead of profit. We just… don’t.

There’s a temptation, when you stare at this long enough, to throw up your hands and go full doomer. “The system is rigged, the politicians are bought, pass the bong and let’s watch something stupid.”

And honestly? Fair. Coping is rational.

But there’s another option: treat healthcare not as a consumer problem but as a labor and power problem.

That means:

Stop playing the role the system wrote for you: isolated patient, anxious consumer, quiet debtor. Start acting like what you actually are: part of a class that’s being shaken down systemically for every last cent we have.

Alright, brain break.

We’ve just spent ~1,400 words beating the everloving hell out of the American healthcare system (deserved), so let’s zoom in on something small, concrete, and occasionally helpful: ashwagandha.

Ashwagandha is one of those herbs that’s been having a “moment” in the wellness world for a hot minute. If you’ve walked through a grocery store supplement/vitamin aisle lately - or mentioned how stressed and sleepless you are to a coworker - you’ve probably heard the hard-sell pitch:

Strip away the branding and you’re basically looking at a plant that’s been used for centuries in Ayurvedic medicine as a sort of all-purpose “please, nervous system, I am begging you - chill” support herb.

In regular-person terms: for some people, ashwagandha seems to take the edge off - especially around chronic stress, anxious or nervous energy, and that wired-but-tired feeling that hits when you finally collapse after work and your brain says, “Cool, now let’s replay every embarrassing thing you’ve done throughout the day.”

If you’re working-class in America, your “baseline” is probably already a mix of:

Ashwagandha isn’t going to cancel your medical debt or strong-arm your boss into offering PTO, but where it sometimes shows up and does something useful is in the margins:

Not in a “Valium in a plant costume” way, more of a “my nervous system isn’t quite as feral as it was last week” kind of thing.

That’s the level of impact we’re talking about: nudges, not miracles.

Let’s be extremely clear about what ashwagandha will not do:

Any product that implies otherwise is selling you powdered copium.

And, again, do the boring, adult thing and talk to a provider who knows your health history before you toss it in the mix—especially if you’re on other meds. Herbs can be tools. They are not substitutes for structural change. Think “slightly better shoes on the same broken road,” not “new highway to utopia.”

There are some people for whom ashwagandha can be a problem, not a solution. Big red-flag categories include (but are not limited to):

If any of that sounds like you, this is not an herb you should just casually add because a podcaster told you to harness your inner warrior or whatever.

If you’re curious about ashwagandha:

And remember: the goal isn’t to optimize yourself into a more efficient cog.

The goal is to suffer a little less in a system that profits from your exhaustion—while you help build something better than this.

If a bitter-tasting root can help you get a bit more sleep or a slightly softer landing at the end of the day, take the win. Just don’t mistake a coping mechanism for a cure.