Now let's ask that question about your health.

You do everything right.

You go to work. You pay your bills. Every month, money comes out for health insurance before you even see your paycheck. You're a responsible person doing the responsible thing.

And still, somehow, the health system never quite feels like it's on your side. You pay in all year. Then a routine visit or a simple lab shows up with a bill anyway. After a while you start to wonder if you're the one missing something.

You're not missing anything. You're just feeling something most people feel but can't quite put into words. So let's put it into words.

Here's a rule that explains more about the world than any headline. Every business makes money from what it sells.

A bakery sells bread. A car wash sells clean cars. Simple. So if you ever want to understand why a business acts the way it does, don't listen to its commercials. Just ask one question. What does it actually get paid for?

Picture a mechanic who doesn't charge to fix your car. He charges for every visit.

So every time your engine sputters, you drive back, he tinkers, and you pay. He's friendly. He's not a crook. But look at what he's actually paid for. Visits, not a fixed car. The day your car runs perfect and never needs him again is the day his paychecks stop.

Would a mechanic like that rush to solve your problem for good? Or would he keep your engine running just well enough to see you again next month?

He's not a bad guy. He's just doing what the money tells him to do. And that, right there, is the trap. Most of our health system is built like that mechanic.

Walk it through with me.

A doctor's office, under the most common setup, gets paid per visit, per test, per procedure. The fancy name is "fee-for-service." That's just a polite way of saying "paid by the piece." More pieces, more pay. That doesn't make doctors bad people. Most got into this work to help you, and they mean it. But the money around them rewards more, not better.

Now the insurance company. Here's where it gets interesting, because there's a rule you should know about.

There is. It's called the 80/20 rule, and it came from the 2010 health law. It says an insurance company has to spend at least 80 cents of every premium dollar on actual care. (For big employer plans, it's 85 cents.) The other 20 cents covers their overhead and their profit. If they don't hit that mark, they owe you money back. In 2024, insurers paid back close to a billion dollars in rebates.

Sounds like a protection, doesn't it? And partly, it is. But read it one more time, slow, and you'll spot the catch.

If the most an insurer is allowed to keep is 20 cents on the dollar, then the only way for them to grow that 20 cents is to grow the whole dollar. Their slice gets bigger when the total bill gets bigger. The rule meant to protect you quietly hands the insurer a reason to not want healthcare to get any cheaper.

Let that sit a second. A cap on their slice turns into a reason to want a bigger pie.

So put the two together.

The doctor's office earns more when more gets done to you. The insurance company's slice grows when the whole thing costs more. And neither one of them earns a single penny on the day you're simply well and need nothing at all.

A healthy person who needs nothing is the one customer this whole system isn't built to want.

A cured patient is a lost customer. A managed patient is a subscription.

That's the feeling you couldn't name. It was never in your head. It's in the wiring.

Let me be clear, because it matters.

Your doctor is almost certainly a good person who wants you healthy. The nurse who calls you back genuinely cares. I'm not pointing at people here. I'm pointing at plumbing, the way the money flows underneath everyone. Good people inside a system with backward incentives still get pulled toward backward results. That's not a conspiracy. It's just water running downhill.

And the nice thing about plumbing is that it can be re-routed.

If the real problem is how the money flows, then the fix is a setup where the company makes its money one honest way, a flat fee, and has no reason to deny you or run up your bill.

That's the idea behind something called health sharing. Instead of an insurance company, a big group of regular people agree to chip in for each other's large medical bills. One of these, called CrowdHealth, charges a flat $60 a month, plus your share of other members' bills as they come up. Because they make their money from that flat fee, and not from a cut of your claims, they have no reason to want your bills to grow. (Full honesty here. I'm a member, and I'll earn a small referral if you ever join through my link. No pressure either way.)

Now the honest other half, because this brand doesn't do bait-and-switch.

Health sharing is not insurance. There's no legal promise that your bill gets paid. It has rules, and things it won't cover. And it's a poor fit for some folks, like anyone managing an expensive ongoing condition who needs guaranteed coverage. It's a real tool, not a magic wand. I'll write a full, fair breakdown of exactly who it's right and wrong for in a future piece.

The point today isn't "go do this." The point is simpler and bigger. Once you see the incentive, you can't unsee it. And you can start asking sharper questions.

You don't have to blow up your life to push back on backward incentives. Start small.

None of this makes you anti-doctor. It just makes you someone who finally understands the game well enough to play it.

Nobody in the system gets paid to make you well. Once you really know that, the surprise bills stop being a mystery and start being a map. And a map is something you can actually use.

Want the plain-English version of money and health, no jargon, no scare tactics, landing in your inbox? Join the Normaltown USA list. One short email, written like a friend, not a brochure.

Nothing here is financial, medical, tax, or legal advice. I'm just a guy who did the homework, sharing what I learned. You make your own calls. This post contains an affiliate link to CrowdHealth. If you join through it, I may earn a referral at no extra cost to you.