Editorial: The Business Sick Care in America
By Dr. Marion Constantinides, DC, PAK, CEO and Best-Selling Author
Meet Matt, Dr. Constantinides’ Husband, this is his first round of FOLFOX being infused for Stage 4 Colon Cancer with metastases to his liver
As I sit in the oncologist’s waiting room beside my husband, I’m surrounded by people—each one a patient with cancer, each one facing the fight of their lives. There’s a line out the door, adults of all ages waiting to see their oncologist, and another line of patients in a row of chairs, waiting to have their blood drawn. This clinic is incredibly efficient, a well-organized center of activity staffed by compassionate doctors, nurses, and support personnel who work tirelessly. But as I sit here observing, I can’t help but see this for what it is at its core—a massive business built around managing illness, particularly the sickness of cancer.
The space itself reflects this reality. It’s not a small clinic but an entire floor of a high-rise building, dedicated solely to working with cancer patients. It’s a maze of hallways leading to exam rooms, treatment bays, laboratory suites, and private offices. Each patient here represents a life, a story—but also, tragically, revenue in the business of cancer that sustains this clinic. As a doctor specializing in natural, functional medicine, it’s hard to ignore that this well-oiled machine depends on the steady influx of cancer patients.
What if we were to shift our focus to prevention and wellness?
If cancer were cured or if preventative health measures were widespread, would this clinic even exist? The compassion of the staff here is undeniable, yet it’s painfully clear that their livelihood depends on a constant flow of patients with cancer. This is not a failure of the individuals working here but of a system that incentivizes treatment over true health, one that builds “sick care” on an industrial scale.
My husband, diagnosed with stage 4 colon cancer at only 45, is now part of this tragic reality. It’s an unexpected journey that raises difficult questions: how did we, as a nation, reach a point where clinics are packed with people facing such serious diagnoses? Why are we not more focused on prevention? Why are sick-care clinics filled to capacity, while well-care clinics are so rare?
Two factors stand out: our diet and the influence of the pharmaceutical industry.
The Standard American Diet is a major culprit. Filled with ultra-processed foods, sugary drinks, and artificial ingredients, our food system fuels chronic inflammation, disrupts metabolic health, and leads to nutrient deficiencies. We are overfed yet undernourished, creating a perfect storm for chronic disease, including cancer. It’s hard to ignore the irony here; food is meant to nourish, but instead, our food system is actively contributing to our disease burden.
Then there’s the pharmaceutical industry, with its overwhelming influence over the health narrative. Billions of dollars are spent each year on advertising, persuading Americans that there’s a pill for every problem. Every ailment has a quick-fix pill, and targeted advertising encourages us to ask our doctors for them. But where is the support for lifestyle changes, for dietary improvements, or holistic therapies? When primary care doctors are overbooked and overburdened, it’s easier to prescribe than to have deeper conversations about health habits that could truly make a difference.
Status Quo In America
Our primary care system has become a reactive machine, managing symptoms rather than addressing the root causes of illness. Doctors are pressured to move patients through quickly, and rarely have time to focus on the lifestyle changes that could genuinely improve people’s lives. This system rewards treatment over prevention, creating a revolving door of patients rather than a culture of wellness.
Imagine if healthcare in America were structured differently.
If our resources went toward promoting wellness, educating people on healthy living, and preventing illness before it starts. Imagine if our health system rewarded prevention as much as it does intervention. We would see fewer waiting rooms like this one and more spaces dedicated to keeping people healthy and thriving.
Reflecting
As I sit here with my husband, grateful for the care he’s receiving but disheartened by the system itself, I am reminded of why I dedicated my life to holistic, preventative medicine. Every day, I work to empower people to reclaim their health by addressing root causes rather than merely treating symptoms. I guide my patients to make lifestyle changes, adopt nourishing diets, and reduce their reliance on medications. My mission is to prevent illness from taking hold, to give people the tools they need to live fully and healthily without being trapped in a cycle of sick care.
It’s even more disheartening that, despite spending more on healthcare per person than any other nation, the United States has a much lower life expectancy compared to other high-income countries. We’re paying the ultimate price for a healthcare system that isn’t keeping us healthy, and we’ve accepted that cost without demanding a shift toward actual wellness. True healthcare—actual health care—is minimally covered by most insurances because healthy people don’t create revenue for insurance companies. We’re left with a cycle where money pours into managing disease, while little is invested in the initiatives that could prevent these diseases in the first place.
It’s time to rethink our approach to healthcare in America. Let’s hold our food and pharmaceutical industries accountable. Let’s shift our focus from sick care to genuine, preventative healthcare. True health isn’t found in a waiting room or a prescription bottle—it’s in our daily choices, our food, our habits. Until we make this shift, we’ll continue seeing too many people, too many families, and too many lives altered by diseases that, in many cases, could have been easily prevented.
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- The High Cost of Cancer Care as a Business
- Understanding and Addressing Cancer Care Costs in the United States in JAMA Network Open: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2784775
- Impact of the Standard American Diet on Chronic Disease
- Ultra-processed food exposure and adverse health outcomes: the importance of considering the nature of food processing in The BMJ: https://www.bmj.com/content/384/bmj-2023-077310
- Pharmaceutical Influence on Healthcare
- Out-of-Pocket Costs, Financial Distress, and Underinsurance in Cancer Care in JAMA Oncology: https://jamanetwork.com/journals/jamaoncology/fullarticle/2648318
- Primary Care as Symptom Management Rather Than Prevention
- Hospital-Administered Cancer Therapy Prices for Patients With Private Health Insurance in JAMA Internal Medicine: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2791386
- Economic Impact of a Reactive Healthcare System in the U.S.
- Comparison of Cancer-Related Spending and Mortality Rates in the US vs 21 High-Income Countries in JAMA Health Forum: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2792761
- Shift Towards Preventative, Holistic Healthcare
- Ultra-processed foods and cardiometabolic health: public health policies to reduce consumption cannot wait in The BMJ: https://www.bmj.com/content/383/bmj-2023-075294
- Insurance Coverage and Preventative Care
- Cancer Care Creates Substantial Costs for US Patients in JAMA: https://jamanetwork.com/journals/jama/fullarticle/2787106