Shareholder Greed Is Undermining American Healthcare
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): The Good Men Project
Publication Date (yyyy/mm/dd): 2025/05/24
A Yale study revealed that between 2001 and 2022, 92 S&P 500 healthcare companies allocated 95% of their $2.72 trillion net income—totaling $2.6 trillion—to shareholder dividends and buybacks, with 19 companies accounting for 80% of these payouts. Sarah M. Worthy, CEO of DoorSpace, criticizes this trend, stating, “American tax dollars are supporting the purchase of health executives’ vacation homes and yachts instead of the healthcare for Americans it’s intended for.” She advocates for clinician-led leadership and strict regulations to limit shareholder profits in healthcare.Worthy emphasizes the need for transparency, accountability, and a shift towards a people-centered healthcare system that prioritizes patient outcomes over executive compensation.
Scott Douglas Jacobsen: What drives the 315% surge in shareholder payouts among healthcare companies?
Sarah M. Worthy: The 315% surge in shareholder payouts among healthcare companies can be traced back to the 1970s, when the philosophy of shareholder primacy began to dominate corporate decision-making. This era marked the start of aggressive lobbying efforts to dismantle policies that had once protected the public from excessive profit-seeking in essential sectors like healthcare. By prioritizing shareholder returns above all else,including patient outcomes and public health,corporations laid the groundwork for today’s crisis. Many healthcare economists now agree that allowing unchecked profit motives to infiltrate the healthcare system was a serious misstep, and reversing this trend is critical for the well-being of both patients and the economy.
Jacobsen: Why did this happen between 2001 and 2022?
Worthy: The period between 2001 and 2022 saw rapid transformation in healthcare, with a major turning point occurring around 2007–2009. This era coincided with the launch of the iPhone and a broader digital shift in how Americans experienced everything,including healthcare. Tech companies from Silicon Valley, working alongside Wall Street and policymakers in Washington, began pushing into the healthcare space with digital tools, platforms, and systems. At the same time, the federal government mandated the adoption of electronic health records, offering funding to help hospitalsand practices modernize their digital infrastructure.
This convergence of government policy, financial incentives, and tech industry influence brought a stronger focus on efficiency, data, and profitability. Around 2010, regulations targeting physician-owned hospitals began to be enforced, and we started to see a significant shift from clinical leadership to MBA-trained executives. These changes solidified the dominance of shareholder-driven priorities in healthcare, setting the stage for the financial patterns we see today.
Jacobsen: How does the shareholder-focused model impact patient care in America?
Worthy: When 95% of healthcare profits are going to shareholders, that leaves just 5% to reinvest in the system. That sliver has to cover pay raises for clinical staff, investments in new technology, cybersecurity upgrades, facility improvements—you name it. And it’s simply not enough to keep the system functioning at the level patients deserve.
This model also makes the high cost of healthcare in America more clear. It’s not about the cost of operations or manufacturing—it’s about profit extraction. Shareholders are taking the bulk of the money that could otherwise go toward lowering insurance premiums, reducing the cost of prescription drugs, or improving access to care. Patients are paying more and getting less, while investors walk away with record returns.
Jacobsen: How do Medicare and Medicaid play indirect roles supporting this profit model?
Worthy: While Medicare and Medicaid do play a big role in the problem of clinician turnover and lack of access to affordable care and are certainly in need of reform as well, I don’t view CMS as supporting this profit model so much as seeing how they’re used as scapegoats by politicians and shareholders to rationalize their greed.
An example to show what I mean by this is we see politicians claim they don’t need to create regulations or policies that restrict for profit greed because Americans who can’t afford private insurance have these government supported options.
Jacobsen: What are some examples of healthcare executives personally benefiting while Americans struggle?
Worthy: Some healthcare executives are making decisions that cost people their health, their lives, and their financial security—and they’re walking away with millions. While Americans are denied care, saddled with medical debt, and forced to choose between medication and rent, these executives face no criminal charges and are rarely held personally accountable in civil court. There’s no legal or financial penalty for profiting off policies that actively harm people.
Many of these executives are not medical professionals. They’re former bankers, consultants, or career administrators whose primary objective is to maximize profits—not improve care. Through a mix of bloated salaries, stock-based compensation, performance bonuses tied to cost-cutting, and golden parachutes, they’re able to accumulate generational wealth. Meanwhile, hospitals in rural and low-income areas are shutting down, nurses are underpaid and overworked, and patients are left waiting weeks or months for basic services.
And let’s be clear—some of those “cost-cutting” decisions include denying coverage for critical treatments, pushing physicians to see more patients in less time, and underinvesting in staff and infrastructure. All of this boosts short-term profit metrics, which inflate executive bonuses—while communities are left to suffer the long-term consequences.
This is not about isolated bad actors. It’s a systemic issue driven by a model that rewards financial performance over human outcomes. When healthcare becomes just another line item for Wall Street, patients lose.
Jacobsen: What can curb healthcare profiteering?
Worthy: Americans must protest to their politicians at state and federal levels, loudly, vigorously and unrelentingly. We must elect the politicians who explicitly refuse to take campaign donations from these for profit healthcare companies. We must demand strict regulations that sharply limit how much shareholders can profit from keeping America sick.
We tried deregulating the industry and letting for profit corporations regulate themselves. That experiment got us to where we are today. It didn’t work. They will not regulate themselves – they will enrich themselves. It’s human nature, perhaps – and laws with big fines and criminal charges for
violations are the only way to resolve this problem so the US Healthcare System works to keep all of us healthy, not support a few billionaires..
Jacobsen: How can everyday Americans take action?
Worthy: We need to stop letting politicians make this a partisan issue. An affordable, high quality healthcare system shouldn’t be up for debate. We have the best doctors and nurses in the world It doesn’t make sense that our healthcare would be the worst in the world and so we need to put the focus back on listening to our clinical experts instead of corporate salesmen and political pundits.
Everyday Americans can start by shifting the conversation. Talk to your friends, neighbors, and local representatives about what’s really going on—about the greed driving up costs and the professionals being sidelined in their own field. We need to start listening to our clinical experts, not corporate salesmen or pundits on TV.
We can also demand more transparency and accountability. Ask your elected officials where they stand on healthcare profiteering. Support legislation that prioritizes patient outcomes over executive compensation. Show up at town halls. Vote with healthcare in mind—not along party lines, but based on who’s actually working to fix the system.
And finally, support movements and organizations that advocate for patients, nurses, and doctors—not shareholders. Push back on hospital closures in your community. Speak up when care is delayed or denied. Change doesn’t come from the top—it starts with people refusing to accept a system that’s broken by design.
Jacobsen: How would a people-centered healthcare system look like, in practical terms in practice?
Worthy: A truly people-centered healthcare system would look very different from what we have today. For starters, we’d see far fewer MBAs in charge and far more clinicians—nurses, physicians, therapists—holding leadership roles in the C-suite and on boards. We need decision-makers who have actually worked at the bedside. People who have stayed up all night comforting grieving parents, or who have had to look patients in the eye and deliver devastating diagnoses.
Right now, too much of what passes as “leadership” in healthcare is just business executives focused on funneling money upward to shareholders. Many of them have no real understanding of healthcare, and they routinely dismiss the expertise of the very people who live and breathe it every day. Clinicians understand the full picture—they navigate hospital systems, patient care, government regulations, insurance bureaucracy, pharmaceutical companies, and tech vendors.
Despite that, they’re often left out of the rooms where major decisions are made. A people-centered model would change that. It would prioritize the lived experience of caregivers and patients, not just profit margins. It would mean listening to those who’ve dedicated their lives to healing—not just those trying to maximize revenue.
Jacobsen: Thank you for the opportunity and your time, Sarah.
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