People believe modern health care is expensive because it is advanced. But the real reason is much simpler: because someone wants profit. From the earliest times to today, paying for your own survival has been a consistent injustice, not a new one. And it continues even though we live in an age where trillion-dollar fortunes sit untouched, where banks own entire hospital networks, and where no one needs to die for lack of care.
Ancient injustice
Even in the ancient world, healing was rarely free. Egyptian medical papyri from as early as 2000 BCE included price lists for specific treatments. The Ebers Papyrus even described complex procedures, showing medicine was an elite profession. In Mesopotamia, Hammurabi’s Code detailed fixed fees for surgical operations—scaled by the patient’s class. Ancient Greek doctors, including followers of Hippocrates, often charged for services. Payment was expected not only in cash but also through gifts or labor.
In Athens, public physicians existed, but wealthy patients still received better care. Roman medicine, similarly, was tiered. Wealthy citizens hired personal physicians—sometimes even slaves trained in healing—while the poor visited temples of Asclepius, where spiritual rituals replaced scientific medicine. Despite mythologies of wise, caring healers, ancient medicine was often a privilege of wealth. There were exceptions—public physicians in some cities, temple healing rituals for the poor—but those were rare, unreliable, and usually less effective. Already then, health was for sale.
Health care: Feudal morals were clearer
Then came the Middle Ages. Surprisingly, this period, though brutal and ignorant in many ways, did not always treat health as a commodity. Monasteries and convents across Christian Europe operated “hospitals” that offered shelter, food, and rudimentary care. These institutions treated the sick for free, not because they were efficient, but because they had values. Healing was an act of mercy, rooted in religious doctrine. Islamic medicine in the medieval Arab world was even more advanced. Hospitals in Baghdad, Cairo, and Cordoba were public institutions, sometimes funded through religious endowments (waqf), offering free care to all classes. Not everyone was helped, of course. Nobles hired private physicians, and city-dwellers paid apothecaries. But the idea that you could walk into a building and get help without first proving financial worth was not absurd yet. Unlike today.
Rise of early capitalism
As Europe secularized and modernized, everything changed. During the Renaissance and early modern period, medicine became professionalized. Universities trained physicians for the elite. Licensing bodies formed. Folk healers, midwives, and herbalists were increasingly banned. Hospitals shifted from religious charity to civic administration, then to commercial operation. Physicians became professionals. Hospitals became businesses. Folk healers disappeared under regulation. The poor were left with unlicensed quacks or nothing. Even charity hospitals started charging, or required social proof and donations. City guilds offered early insurance, but only to the privileged. Healing became a transaction.
Industrial age and health stratification
Industrialization brought factories, cities, pollution, and disease. It also brought a health care market. In 19th-century cities, industrial workers crowded into slums while doctors worked in private practice, charging fees most could not afford. Hospitals created private wings for paying patients and overcrowded charity wards for the poor. Some industrial employers created sickness funds or company doctors, but these were often paternalistic, limited, and tied to labor discipline. The poor died younger, sicker, and more often. Early health insurance models appeared in Germany under Bismarck in the 1880s, but access was tied to work status and did not extend to all. The U.S., France, and Britain lagged behind. There was no principle of universal care—only selective help, rationed by wealth, class, and geography.
Modern age: The great split
After the world wars, a strange divergence occurred. Western Europe built welfare states to prevent a communist mood from spreading—while communist countries had public healthcare from the start. Health care became public in Britain with the founding of the NHS in 1948. France, Germany, and Scandinavian countries created national systems or universal insurance. These systems treated health as a right, not a product.
But the United States went in the opposite direction. Employer-based private insurance became the norm. Medicare and Medicaid were introduced in the 1960s, but only for the elderly and poor. Insurance companies grew powerful. Hospitals merged into corporations. Medicine became a financial empire. Meanwhile, the rest of the world suffered under structural adjustment, IMF diktats, and broken promises. Countries in Africa, Latin America, and South Asia were forced to cut public health spending in exchange for loans, leaving generations with no care. Even where health care was once public, privatization returned.
Health care today: obscene wealth, rationed care
Now we live in a world where artificial intelligence can diagnose diseases in seconds, but insulin costs more than rent. Where biotech firms sit on trillions, but children die of treatable infections. Where private equity buys hospitals, cuts staff, raises prices—and leaves communities with empty shells. Insurance companies deny coverage based on fine print. Hospitals send patients to collections. Big Pharma blocks generics to protect patents. And still, we are told this is progress.
In the U.S., medical debt is the leading cause of personal bankruptcy. Also, in India, out-of-pocket spending forces millions back into poverty every year. In Nigeria, even childbirth can lead to catastrophe if complications arise. Meanwhile, executives earn bonuses for denying claims. Billionaires attend longevity clinics. The World Bank funds hospital privatization while claiming to fight poverty. Everything exists. Resources, knowledge, labor. Only access is missing.
The biggest lie
The system claims health care must cost money. But why? The labor exists. The technology exists. The drugs already exist. It is not scarcity. It is hoarding. Medical billing, patents, middlemen, insurance loopholes—all exist to extract, not to heal. And yet the media never frames it that way. Politicians call it complicated. Economists avoid it. Philosophers ignore it. Meanwhile, millions suffer.
They do not suffer because care is impossible. They suffer because someone profits. The real illness is not biological—it is structural. The health system is not broken. It is designed this way. And it works exactly as intended. Just not for you.
Eight million deaths — not from disease, but from system failure
Every year, around eight million people die. Not from rare illnesses. Not from untreatable conditions. But from something far more preventable—healthcare failure.
Across low- and middle-income countries, about 2.9 million people die simply because they never reach a doctor. No access, no infrastructure. No care at all. But that is only part of the picture.
An even greater number—5.7 to 8.4 million—die because the care they receive is inadequate. Misdiagnoses. Wrong treatments. Outdated equipment. Undertrained staff. The system touches them, but it fails them. And the result is the same: unnecessary death.
We talk about viruses, we talk about famine. We talk about war. But the quiet killer is bureaucratic, systemic, and slow. It is a clinic without medicine. A hospital without electricity. A health ministry that looks good on paper but does not work.
These deaths are not random. They follow patterns. The poor die more. The rural die more. The politically neglected die more. And almost all of them die without making headlines.
If we had functioning health systems—global, fair, and equipped—millions would live. They are not dying from nature. They are dying from neglect.
Not only could people from rich countries or their respective governments change it all, but the super-rich are also sitting on tens of thousands of trillions of dollars.
A moral failure of our time
We are no longer in the Middle Ages. We are worse. They had plagues and ignorance, but also compassion. Today, we have precision tools, global networks, and infinite capital—but no ethics. Even a feudal baron would not let his serfs die for lack of a prescription. Today, billionaires do. And they do so through lobbyists, price gouging, privatization, and silence.
Health care is not a luxury. It is not a car, or a vacation, or a handbag. It is breath. And it is life. And yet, our systems continue to treat it as a market. Nations compete on patents, not outcomes. Hospitals build glossy wings for VIPs while emergency rooms collapse. Pharmaceutical executives block vaccine access while speaking at Davos.
We could end this tomorrow. But we will not. Because the people who could change the system are the ones who own it.
Final word
Health care should never have been paid. It should not have existed as a business. It does not belong in the market. And it does not belong even to the moral framework of the Middle Ages. The fact that it still costs money proves only one thing: we are not civilized. We are rich. We are powerful. But we are not moral. Not yet. Not until we stop charging people for the right to live.
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