Are you one of the majority of Utahns who have faced increasing healthcare costs? Whether it be higher deductibles, increasing premiums or facility fees, our already exorbitantly high healthcare costs continue to rise at an unsustainable rate.
While the U.S. healthcare system is the most expensive in the world, we have worse health outcomes, such as a lower life expectancy, than any other developed country worldwide. This should be unacceptable, especially as costs continue to rise.
The burden of high healthcare costs
In Utah, average healthcare spending increased 8.3% from 2022 to 2023. We are the fourth most expensive state in the nation for hospital care. Almost 70% of Utahns reported experiencing a healthcare cost burden last year and 7% of Utahns carry medical debt and are at risk of bankruptcy as a result.
Premiums for employer-based insurance are increasing faster than wages and inflation. The cost of healthcare in Utah is untenable. As a physician, I have met many families who have had to choose between buying their child’s expensive asthma inhaler or paying for rent, for example.
As a pediatrician, I have seen many families suffer from the high cost of healthcare, especially hospital stays, and especially if they are on the health insurance bubble. For example, a family of two working adults and two kids will be kicked off Medicaid due to the parents making “too much money” at their low-wage hourly jobs (that don’t offer health insurance).
For a family of four, the maximum amount of income allowed to qualify for Medicaid is $43,896, which works out to $10.55 an hour for full-time work per adult. If this family’s uninsured child ends up hospitalized, the family could end up in financial ruin. An inpatient stay at Primary Children’s Hospital was billed an average of $23,630 per hospital day in 2025. Why?
The price of big hospital systems
Costs are high in Utah for many reasons. One is that Utah’s healthcare system is considered a highly consolidated healthcare state, which means it has characteristics of a monopoly. Intermountain Health owns the most healthcare facilities, followed by University of Utah Health.
This lack of competition leads to increased healthcare costs and without competition, there is no pressure to prioritize controlling their costs. This results in such things as compensating health systems’ CEOs upward of $26 million per year.
I think the priority in healthcare spending should be on things that improve the quality of care. Fancy waiting rooms, self-playing pianos or paying executives millions of dollars do not add to the quality of care. It only adds to the cost.
Of the $4.9 trillion that the U.S. spent on healthcare in 2023, 31% was spent on hospitals. But nowadays, what is considered outpatient versus hospital spending? It has become complicated to answer.
Have you noticed on a bill something called a “facility fee?” This is supposed to cover the overhead of the facility. Independent practices usually don’t charge this, or it is minimal. However, when a physician practice is bought by a hospital system, or a hospital system opens an outpatient facility, for example, the hospital system can charge as if the appointment or procedure was done in a hospital, instead of in an outpatient setting. Hospitals say it is to pay for things like keeping an ER open 24/7, even if on your visit you are going to a regularly scheduled outpatient doctor’s visit, not the ER.
If you’re self-pay, it is even worse. According to the University of Utah Health’s cost estimator website, the fees for an MRI scan of a wrist are $2,198. Of this, $1,793 is hospital charges (the facility fee) and $405 is physician charges. If you don’t want to pay this high amount, you can go to a free-standing MRI center in the valley and pay $399 for the same MRI (translation — the physician charge, no facility fee). These images are both read by board-certified radiologists. This charge difference is appalling.
This is a frustrating time to be a healthcare consumer in Utah. I will be talking to my state legislators about what can be done at the state level about these funding issues. I encourage you to do so as well.