The tragic and shocking murder of the UnitedHealthcare CEO has ignited a nationwide conversation about the flaws in the health care system, often accompanied by misdirected anger toward physicians. The rhetoric suggesting that physician salaries are the root of the problem oversimplifies a complex issue and distracts from systemic failures.
Physician salaries account for only about 8 percent of total U.S. health care costs, according to the American Medical Association, Health Affairs Journal, and PwC Health Research Institute. This modest percentage contrasts sharply with the staggering $4.7 trillion spent on health care in 2023, which encompasses hospital services, medications, and expansive government programs like Medicare and Medicaid. To put it bluntly, even if doctors worked for free, the structural issues in our health care system would persist.
Becoming a physician entails immense sacrifices: years of education, hundreds of thousands in student debt, and grueling residencies where compensation often equates to minimum wage. These realities underscore why blaming physicians not only ignores the true cost drivers but also undermines the profession’s societal value.
Through my training in diverse health care settings—managed care organizations, academic hospitals, public health systems, and government-funded institutions—I have witnessed both the system’s potential to empower patients and its failures to bridge the gap between affordability and quality care. Rising costs have created an adversarial dynamic between patients and providers, breeding mistrust in a system that should prioritize accessibility and transparency.
A critical barrier to equitable care is the lack of transparency surrounding costs of services in health care. Patients, physicians, and even health care providers often lack clear information about the prices of tests, procedures, and treatments. This creates a vicious cycle of confusion, frustration, and fear. For instance, my personal experience attempting to access medically indicated care highlighted this dysfunction. After an exhaustive process to obtain an estimate for an endoscopy and colonoscopy—tests my own physician deemed medically necessary due to my family history—I faced a projected $800 out-of-pocket expense. Like many others, this proved to be beyond my financial reach at the time. While my condition wasn’t life-threatening, countless patients with severe illnesses face similar dilemmas, choosing between medical debt and potentially life-saving care.
This lack of transparency and affordability is not just a logistical issue—it is a moral one. The U.S. health care system forces millions to delay or avoid essential care, exacerbating preventable suffering and death. These inequities erode public trust and, in extreme cases, provoke violent reactions born from desperation and frustration.
So, where do we go from here? As physicians, patients, and institutional stakeholders, we must collectively advocate for transformative change. Physicians must engage in policy discussions and push for reforms that prioritize patient welfare over profit. Many of us entered this field to help others, and this is certainly our chance to do so. Institutions must commit to transparency in pricing and advocate for systemic reforms to reduce costs and increase accessibility. Health care is a matter of public health, not a business endeavor. Most importantly, we must remember that we are all potential patients—or have loved ones who currently are.
Health care is a human right, and as such, one should not die because they cannot afford care. Similarly, no one should face violence because they are perceived as part of an unjust system. It is time to stop shifting blame to those who sacrifice to provide care and start holding the broader system accountable. The stakes have never been higher, and the call to action has never been clearer: We must do better—for our patients, our communities, and ourselves.
Emma Fenske is an internal medicine resident.
