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NHH CEO Admits US Healthcare System 'Broken'

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  Published in Health and Fitness on Monday, March 2nd 2026 at 17:21 GMT by Forbes
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New York, NY - March 2nd, 2026 - In a stunningly candid admission, Susan Diamond, CEO of National Horizon Health (NHH), a leading US health insurance provider, has publicly acknowledged the systemic failures of the American healthcare system, shifting away from traditional industry defenses and placing responsibility squarely on all stakeholders. Diamond's remarks, made during a televised interview on 'The Future of Healthcare' program, are already reverberating through Washington and prompting renewed calls for comprehensive reform.

Diamond's core argument isn't a novel one - the US healthcare system is broken. However, her willingness to attribute blame across the board - to patients, providers, insurers, and policymakers alike - is unusual for a figurehead of a major insurance company. For decades, the industry has largely deflected criticism, often pointing fingers at government regulations or individual patient choices. This move marks a significant departure.

"For too long, we've engaged in a blame game," Diamond stated. "It's been 'their fault, not ours.' But the reality is, we've all contributed to the current crisis. We, as insurers, haven't been aggressive enough in pushing for transparency. Providers haven't focused sufficiently on preventative measures. Patients haven't always been proactive about their health. And policymakers have been slow to enact meaningful changes."

Diamond specifically highlighted three key areas fueling the escalating costs and declining accessibility of care: a pervasive lack of price transparency, an underinvestment in preventative care, and the crushing weight of administrative bureaucracy.

The Price of Secrecy: A System Obscured

The lack of price transparency, Diamond argued, is a "fundamental flaw" in the system. "Patients routinely receive bills for procedures with no prior knowledge of the cost. They are essentially buying healthcare in the dark. This leads to surprise billing, financial hardship, and erodes trust in the entire system." NHH, she revealed, has been piloting a program offering real-time price estimates for common procedures, but acknowledges scaling such a program nationwide requires industry-wide cooperation and potentially legislative mandates. Data from the pilot program shows patients who have access to cost estimates before receiving care are significantly more likely to shop around for better prices and choose lower-cost alternatives.

Prevention is Better (and Cheaper) Than Cure

Diamond also emphasized the critical need to prioritize preventative care. "We spend the vast majority of our healthcare dollars treating illness, not preventing it. Investing in wellness programs, early screenings, and chronic disease management is not just the right thing to do, it's the smart thing to do economically." She cited research indicating that for every dollar invested in preventative care, up to $6 can be saved in downstream healthcare costs. However, the current fee-for-service model incentivizes treating sickness, rather than maintaining health.

Administrative Overload: A System Choking on Paperwork

Administrative complexity, Diamond admitted, is another major drag on efficiency and affordability. "The paperwork, the coding, the pre-authorizations... it's an incredibly wasteful system. A significant percentage of healthcare spending goes towards administrative costs, not actual patient care." She championed the ongoing efforts to standardize claims processing and promote interoperability between different healthcare IT systems, but warned that progress is too slow.

Shifting to Value-Based Care: A Path Forward?

Diamond's most significant proposal centers on a fundamental shift from a fee-for-service model to a value-based care approach. "We need to move away from rewarding volume and towards rewarding outcomes," she explained. "It's not about how many procedures we perform, but about how healthy our patients are." This requires a commitment to data-driven evaluation, shared accountability, and a willingness to embrace innovative payment models. NHH is actively exploring bundled payments and accountable care organizations (ACOs) as potential pathways towards value-based care.

Diamond's comments have sparked immediate reaction. Consumer advocacy groups have praised her candor but called for concrete action. "Words are not enough," said Maria Rodriguez, Executive Director of Healthcare Access Now. "We need to see NHH, and other insurers, actively lobbying for policies that promote transparency, preventative care, and value-based reimbursement." Republican and Democratic lawmakers alike have indicated a willingness to revisit healthcare reform proposals, though deep partisan divisions remain.

The future of US healthcare remains uncertain. But Susan Diamond's bold statement, and the potential for genuine collaboration she envisions, offers a glimmer of hope that a more equitable, affordable, and effective system might finally be within reach.