The Problem With Our Health Care System Is It Ain't Broken

A Fort Worth physician argues that rising costs, rushed appointments, and endless bureaucracy are not system failures but the predictable results of incentives built into modern health care.

Published on Mar. 9, 2026

Got story updates? Submit your updates here. ›

In this commentary, Dr. Anatoli Berezovsky, a Fort Worth family medicine physician, argues that the U.S. health care system is not broken, but rather functioning exactly as designed to generate profits for large insurance companies and health care providers. He explains how the current system incentivizes higher costs and lower quality of care, and suggests that the solution lies in moving away from insurance-based primary care towards a Direct Primary Care model that prioritizes patient access and affordability.

Why it matters

This perspective challenges the common narrative that the U.S. health care system is simply broken and in need of reform. Instead, Dr. Berezovsky contends that the system's issues, such as rising costs and poor patient outcomes, are intentional features designed to maximize profits for the industry's largest players. Understanding this dynamic is crucial for developing meaningful solutions that address the root causes of the system's problems.

The details

Dr. Berezovsky explains how large insurance companies and health care providers artificially inflate prices and costs, taking advantage of a lack of price transparency. He notes that insurance companies are legally required to spend 80% of premiums on claims, incentivizing them to inflate claims to generate higher profits. Similarly, health care providers raise their listed prices when insurers negotiate to pay only a small fraction of those prices. This lack of transparency and the existence of inflated prices lead to the assumption that health insurance is necessary for health care, when in reality the system is designed to perpetuate itself at the expense of patients.

  • The Fort Worth Report recently hosted a conversation on how to curb soaring health care costs for all Tarrant County residents.

The players

Dr. Anatoli Berezovsky

A husband, father, and family medicine physician who founded Mila Family Health, a local Direct Primary Care practice. He is also employed part-time at JPS, where he works with residents in prenatal care, labor and delivery, and inpatient medicine.

Mila Family Health

A Direct Primary Care practice founded by Dr. Berezovsky that provides affordable, transparent primary care services to patients.

Got photos? Submit your photos here. ›

What they’re saying

“When it comes to the health care system, a common question is: Why is it so broken? The uncomfortable answer is that it isn't. The system is functioning exactly as designed, getting exactly the results it was built to get. And that's the sad part.”

— Dr. Anatoli Berezovsky, Family Medicine Physician (fortworthinc.com)

“Because of this lack of price transparency and the existence of artificially inflated prices, we assume that health insurance is necessary for health care. Thus, we focus on 'uninsured' rates rather than 'uncared for' rates. We work to get people 'coverage' rather than 'care.' More coverage in a broken system only entrenches it.”

— Dr. Anatoli Berezovsky, Family Medicine Physician (fortworthinc.com)

What’s next

The path forward starts with clarity. First, stop using "health insurance," "health care," and "health" interchangeably. They are not equivalent terms. Second, consider whether there is a better way for you and your family to get the care you need, and wherever possible, pay for that care directly, cutting out the middleman. This applies to individuals and families as well as to employers. Finally, ask yourself an uncomfortable question: how am I part of the problem?

The takeaway

This commentary highlights the systemic issues within the U.S. health care system, where rising costs and poor patient outcomes are not failures but rather the intended results of a system designed to maximize profits for large insurance companies and health care providers. Understanding this dynamic is crucial for developing meaningful solutions that address the root causes of the system's problems.