This article is the fourteenth in CPJ’s Ink & Impact series featuring young writers from across the country. In today’s political climate, often marked by cynicism and despair, CPJ’s annual Ink & Impact conference helps Christian young people become messengers of hope. In a world dominated by digital distractions, Ink & Impact develops writers who can articulate complex political topics in an approachable, nuanced way to inform the public. The views and opinions reflected in these articles are those of the authors and do not necessarily reflect the official position of CPJ.
Everyone is affected by their quality of health. Broken bones need fixing, red-hot fevers need treating, and cavities need filling. The human body requires a lot of maintenance, which is not only mentally and emotionally taxing but expensive. On top of that, the administrative complexity of the U.S. healthcare system creates unnecessary barriers that keep people from accessing the care they need.
The Cost of Healthcare Administration in the U.S.
In 2024, U.S. healthcare spending totaled $5.3 trillion, twice the per capita spending of other wealthy countries. The U.S. coughs up nearly four times as much per person on administration compared to similar countries. Chief among the reasons for this is complicated or lengthy administrative tasks. These tasks might include but are not limited to scheduling, resolving billing issues, and completing numerous forms, such as consent to treat, HIPAA privacy acknowledgment, financial responsibility, informed consent, insurance, and billing forms. Such tasks can delay or completely prevent patients from receiving care. A 2021 study found that nearly a quarter of survey respondents reported foregoing or delaying care because of hurdles involved with coordinating services. Similarly, administrative tasks disproportionately affect different groups of people. For example, the elderly and those with disabilities are two demographics that face more administrative tasks relative to others as both often manage multiple health conditions that heighten the difficulty of coordinating care across multiple providers and specialists. While it is easy to think of administrative tasks related to healthcare as mundane and unimportant, administrative burdens not only prevent patients from receiving care but also affect their progress across the whole healthcare cycle, from seeking care to receiving it to following up on issues.
One of the major problems with the U.S. healthcare system is not that these tasks exist, but rather that the system has been defined by a fragmented “add-on” way of thinking where increasingly complex policy elements, such as employer-offered insurance and the Affordable Care Act’s private marketplace plans, have been added to “patch” holes where there is a need for coverage. Because of this, these elements were not crafted to work together. The current third-party-payer system grew out of employer-offered health insurance created during and after World War II. From there, landmark legislation like Medicaid, Medicare, and the Affordable Care Act filled in these gaps instead of centralizing a national strategy. Without greater coordination in healthcare administration, the U.S. will continue to face significant costs and gaps in care for its citizens.
One of the results of this fragmented system is that more than 28 million Americans under 65 are uninsured. Additionally, administrative barriers such as reliance on paper documentation and unnavigable web formatting keep many of these Americans, many of whom have extenuating circumstances like disabilities or mental health disorders, from applying for Medicaid. It has even been demonstrated that 70% of the 15 million people who lost Medicaid since 2023 because of the unwinding process of continuous enrollment—an administrative procedure—were disenrolled for simply not completing a step in the renewal process, not because they were ineligible for the program. For these disenrolled people and many more, the gap between need and care is not an abstraction—it is a daily reality that shapes their health, their finances, and their futures.
Looking at the Whole
Since God is the creator and sustainer of all things, Christians are called to care not for just a fraction of humanity’s health but instead health for the whole person—body, mind, and spirit. Human beings are made in the image of God, and their physical wellbeing carries inherent dignity. Jesus’ earthly ministry reflected this. He did not separate spiritual renewal from physical healing. If God himself did not ignore the physical plights of humanity while on earth, why should we? Consider the man with paralysis brought to Jesus through a roof in Luke 5:17-26. The man’s friends go to great lengths to get him to Jesus, who they know can heal him. Or consider when Jesus heals Peter’s sick mother-in-law in Matthew 8:14-15. All that happens in the Matthew passage is that Jesus enters Peter’s house. Access is all it took for Peter’s mother-in-law to regain her health. Consider also the man whose illness left him unable to walk, whom Jesus met by the pool of Bethesda in John 5:1-14. He had struggled with this disease for 38 years, and his access to the healing power of Bethesda’s pool was limited because he could not walk. Jesus didn’t just help the man get to the pool. Instead, he healed his whole body. Access to Jesus is what the ailing man needed.
To address the administrative burdens that keep people from accessing the care they need, we must recognize how government, civil society, and individuals are each called to act in order to uphold public justice. Public institutions like schools and hospitals carry distinct responsibilities to accomplish their functions, and so do churches, social organizations, the family unit, and the political community. Citizens play a leading role in the political community. The Center for Public Justice’s guidelines for citizenship say that citizens “help to shape the political community in order for it to conform to the demands of justice.” In the context of healthcare administration, this looks like providers and patients working together to advocate for a coordinated system. Patients and providers alike can share their experience to shape how reform is enacted. As Abraham Kuyper said, “there is not a square inch in the whole domain of our human existence over which Christ, who is Sovereign over all, does not cry, ‘Mine!’” And so let us reach out to one another and to our vulnerable neighbors with a desire for justice.
Bringing Health Back
One of the ways the U.S. government can save money as well as increase satisfaction for patients and providers is by creating a centralized, automated clearinghouse (ACH) to reduce the time and resources that providers’ offices spend coordinating with insurance companies. Automated clearinghouses have been a major part of the banking industry since the 1970s. As banking infrastructure grew in the computer age, there was an increasing need to move money across institutions. The banking industry created a standardized, automated way to meet that need. The healthcare industry today faces a very similar problem. While health clearinghouses do exist, they do not serve as a central hub for patients navigating billing and information needs. If the federal government created a central clearinghouse that promoted the sharing of data and billing processes to streamline administration and lessen burden, it could clear the hurdles that current clearinghouses face.
Another way that the other parts of our pluralistic society can live up to the demands of justice is by supplying resources and information to those struggling to overcome the administrative burdens of the healthcare system. Churches, individuals, and nonprofits can cover otherwise unaffordable costs for those in need, connect them with the information and proper resources to surmount administrative obstacles, and, in some circumstances, provide care directly.
One organization that embodies this vision is InterFaith Health Center. InterFaith has provided comprehensive, affordable care for underserved and uninsured individuals in my hometown of Knoxville, Tennessee since 1991. A group of like-minded members of different faith communities—across traditions, hence the name—saw a need for local care for the uninsured. For many uninsured patients, the path to care begins with navigating a complex administrative system. According to Beth Roskelly, Director of Development and Public Relations at InterFaith, the largest group of patients the organization serves work in service industries like food or retail. Many other patients have jobs that may not provide health coverage, such as those who work part time for churches, nonprofits, or other charitable organizations, employees of small businesses that can’t afford benefits packages, or people who are between jobs.
Over 30 years of open doors, InterFaith has provided 400,000 patient encounters to over 24,000 East Tennesseans. InterFaith has been planted in the community for decades, drawing support from many citizens who want to see justice brought about through physical care. Physicians and other volunteers with medical degrees give their time to do just this. Just short of 2,000 medical volunteer hours were provided by community members from 2024-25. According to Roskelly, the organization has a pool of 200 volunteer specialists who provide medical care in specialties like dermatology or podiatry, charging patients only 10% of the standard cost. InterFaith’s model is just one example of what becomes possible when communities commit to care.
The responsibility and desire of democratic society to be just begins with the citizen’s ability to right wrongs at a level that can seem small. If you want to improve the ability of your neighbors to access healthcare, think about driving them to a medical appointment or sitting down to help them understand their insurance coverage. Encourage neighbors to navigate the system and help connect them to experts when needed. Ask your provider how you might be able to help neighbors with forms. Listen to the stories of those with health conditions of all kinds. Offer an empathetic ear to people who express frustration about their opportunity, or lack of it, to receive quality healthcare. Remember that you may have an opportunity to help someone today simply by asking what their needs are. When citizens care for each other, the whole community gets stronger—and that is a form of justice.
Jackson Schriver studies public affairs at the University of Tennessee, Knoxville. He is interested in pouring into the economic, spiritual, and communal life of his hometown and bringing God’s kingdom to bear through loving justice.
Graphic by Center for Public Justice
