The United States has often portrayed itself to be the leader of the free world, protector of the oppressed, a country where anyone can come and if they just work hard enough and earn an honest living, he will move up in the world and earn more richest than many nations combined. However, behind all the glamor and glitz lies a dark underbelly. America has many problems, be it sexism, racism, homophobia, discrimination against immigrants, classism and major wealth disparity, and one of the biggest issues that the country faces is its healthcare, or lack thereof. America tends to hold a unique position in the developed world, being one of the most advanced economies in the world and yet not even having universal healthcare. Even its neighbor and often bitter rival Cuba has a healthcare that is miles better than the US, even though the country is behind the US in every other way.
So how exactly did it come to be that the biggest, most powerful country in the world, as evidenced by the most powerful militaries in the world in 2020 which the US easily tops, doesn’t afford its citizens a basic right to health? Well, the story is somewhat weird while for others it may just be a typical example of the US being US. Initially, hospitals and doctors were not regulated. This is back in the 19th century, where anyone could basically one day get the urge to be a doctor and instead of having to undergo rigorous studies and practice, they could just start operating on people who were only too happy to let them. Snake oil was the name of the game back then, and due to the lack of regulations, healthcare was extremely cheap (about $100 a year) and not very effective. However, over the last 200 years, healthcare not just in the US but in the world has improved significantly as techniques were improved, breakthroughs were made and lives were saved and improved. This saw extremely cheap healthcare being offered to teachers for 50 cents a month in Dallas, which was soon copied by most hospitals across the country who offered such plans to worker groups.
RossHelen/Shutterstock.com
Then came World War II, after which the US emerged as a victor, which saw a boom in the economy which led to employers having to complete for employees, and in lieu of good salaries due to FDR freezing wages, these companies would offer cheap healthcare, which was also exempt from tax by the IRS. Since employer based healthcare covered two thirds of the population, any plans for universal healthcare, which to be fair earlier presidents did try to go for, but was blocked by the businesses, who would have to offer actual decent wages if universal healthcare became a thing and that was that.
Now here’s the kicker: if you live in the United States or if you’ve read about their healthcare, you’ll know about insane the margins on every and anything related to healthcare. You could go in for routine surgery and be out for tens of thousands of dollars if not hundreds of thousands of dollars. It is often actually cheaper to fly to another country, vacation there, have the surgery done and return than it is to get the same surgery in the US. The aforementioned employer based healthcare is the reason behind that. These companies have insurance for their employees and the hospitals and insurance companies, both of which have a lot of power, haggle around the prices and reach a compromise which leaves no one happy, but at least those with health insurance get to go home without a bill worth several months of their salary. on the other hand, those with no insurance have no power to fight these charges, and are often at the mercy of hospitals. It is incredible to think this is the state of affairs in the one of the most developed countries in the world, but that is the bare truth of it. Even insurance costs can vary significantly and especially by state, which is why you might want to take a look at the 10 states with the most expensive health insurance premiums and the 10 states with the cheapest health insurance.
The US is also home to some of the biggest biotech companies in the world, which are also some of the biggest pharma companies in the world. These companies earn tens of billions of dollars in revenue each year, while their income is also in the billions. On the other hand, we also have some of the largest hospitals and health systems in the US. These health care systems have hundreds of thousands of registered or affiliated nurses and physicians, and have tens of millions of patient encounters each years. These health care systems are also responsible for hundreds of hospitals, which include some of the biggest hospitals in the US which in turn have thousands of beds each! The biggest hospital in the US is Barnes-Jewish Hospital which has 1,638 beds and is part of BJC HealthCare, while the second biggest hospital Yale New Haven has more than 1,500 beds and sees more than 1.5 million patients alone annually. The numbers and data for our ranking is taken from the Becker Hospital Review, which conducts the most in depth analysis of this kind each year. So let’s take a deeper, more insightful look into these hospitals and health systems, responsible for saving and helping millions of people across the country, starting with number 15:
15. Atrium Health
Number of hospitals: 36
Atrium Health has around 65,000 employees and earned around $9.9 billion in revenue in 2019.
ChaNaWiT/Shutterstock.com
14. Vibra Healthcare
Number of hospitals: 45
This 16 year old health system now has more than 6,000 employees as well as 45 hospitals in 14 states.
Syda Productions/Shutterstock.com
13. Prime Healthcare
Number of hospitals: 46
Founded in 2001, Prime Healthcare is associated with the nonprofit Prime Healthcare Foundation. It has operations in 15 states.
ldutko/Shutterstock.com
12. AdventHealth
Number of hospitals: 49
One of the few non profit based health systems among the largest hospitals and health systems in America is AdventHealth, which was founded 47 years ago in 1973.
ESB Professional/Shutterstock.com
11. Bon Secours Mercy Health
Number of hospitals: 50
It has 50 hospitals with 2,600 providers and around 60,000 team members as well, and is one of the many Catholic health systems you will see as you continue in this list.
wavebreakmedia/Shutterstock.com
10. Providence
Number of hospitals: 51
Providence Health & Services is a Catholic health system and has around 120,000 employees. In 2020, it obtained more than $500 million from the government amidst the coronavirus pandemic.
Billion Photos/Shutterstock.com
9. Baylor Scott & White Health
Number of hospitals: 52
Baylor Scott & White Health was formed recently, just 7 years ago in 2013, and in addition to its 52 hospitals, also has around 7,300 physicians and more than 1,000 care sites. The health system has around 7.5 million patients every single year and with its 49,000 employees, provides high quality health care which is why 17 of its hospitals are featured among reports of America’s best hospitals.
Photographee.eu/Shutterstock.com
8. Tenet Healthcare (NYSE:THC)
Number of hospitals: 65
Tenet Healthcare is a major healthcare company with 65 hospitals and more than 500 healthcare sites, and is one of the oldest health systems in our list, having been founded 51 years ago in 1969. The company earned $18.4 billion in revenue in 2019 and made a net loss of around $232 million. It employs 113,000 people and has grown over the years both organically and through major acquisitions. It has been involved in major controversies including psychiatric fraud, unnecessary heart surgeries, medicare fraud and tax dodging, which is why its reputation is not as golden as some of the other companies here.
Africa Studio/Shutterstock.com
7. LifePoint Health
Number of hospitals: 88
The 21 year old health system has 88 hospitals present in around 30 states, and earns nearly $9 billion in revenue each year. The company has 60,000 employees and is considered to be one of the best companies in healthcare when measured by quality.
Photographee.eu/Shutterstock.com
6. Trinity Health
Number of hospitals: 92
You will see a few Catholic health systems in our list, and Trinity Health is no exception. The health system has around 119,000 employees, of which 5,300 are physicians and earned over $18 billion in 2019 alone. It serves 20 US states.
Monkey Business Images/Shutterstock.com
5. Community Health Systems (NYSE:CYH)
Number of hospitals: 93
Community Health Systems has a history of more than 30 years, in which it has been acquiring hospitals and is now present in 16 states in the United States. It is traded on the stock exchange and has earned more than $18 billion in revenue in 2019, while also earning a healthy operating income. It currently has 120,000 employees and Chinese billionaire Tianqio Chen has a 22.2% ownership in the Fortune 500 company.
Yuganov Konstantin/Shutterstock.com
4. CommonSpirit Health
Number of hospitals: 137
The second biggest Catholic healthcare system in the US is CommonSpirit Health, which has more than 700 care sites and has around 150,000 employees. It was only founded in February 2019 after the merger of two non profit hospital systems. 25,000 physicians help treat millions of patients in 20 US states and it is the most recent health system in our list.
Stokkete/Shutterstock.com
3. Ascension
Number of hospitals: 151
Ascension is one of the biggest private healthcare systems in the world, and its no surprise that it earns a place in our list of largest hospitals and health systems in America, and was founded 21 years ago in 1999. The health system has around 150,000 employees and is a Catholic enterprise, which earned around over $550 million in operating income and over $15.5 billion in cash while also operating a venture fund. It operates around 2,700 sites and is active in 20 states in the US, reporting around 25 million patient visits every year in addition to over 3 million ER visits.
Pressmaster/Shutterstock.com
2. Veteran’s Health Administration
Number of hospitals: 170
Veteran’s Health Administration leads me to another path where I could discuss another major issue plaguing the US, in how it treats its veterans. Now, I count myself among the people who think the US’s decision to become a self appointed defender of wrongs in the world and invading countries causing more damage than relief is a misguided one at best, but how it treats it veterans is horrendous, which is why veterans have abnormally high rates of suicide and homelessness. However, the Veteran’s Health Administration, administered by the United States Department of Veteran Affairs, which has been said to provide a quality of care which is even better than that found privately, and this is mainly thanks to an annual budget of around $85 billion.
Minerva Studio/Shutterstock.com
1. HCA Healthcare (NYSE:HCA)
Number of hospitals: 186
Topping the list of the 10 largest hospitals and health systems in America is HCA Healthcare, which has 186 and nearly 100,000 registered nurses across the world, in addition to around 46,000 active and affiliated physicians. The health care system is responsible for the treatment of around 35 million patients, while also accounting for 9.2 million emergency visits. Unfortunately, in an indictment of American healthcare, it is a for profit company, which means its focus is on profits and not providing affordable healthcare to the country. This has allowed it to earn over $50 billion in revenue in 2019 alone, which is why Fortune named it one of the biggest companies in the US.
It also had profits of more than $3.5 billion while providing to more than 280,000 people. While it is mainly based in Nashville, Tennessee it has a strong presence in more than 21 states across the US as well as the UK and in addition to the 186 hospitals, also has more than 2,000 sites of cares as well. The company also publishes medical studies in peer-reviewed journals and surprisingly for an American healthcare company, has actually consistently been called among the most ethical countries in the entire world. In fact, it has been in the most ethical companies in the world list by Ethisphere Institute since 2010 and hasn’t dropped off since.
See also: 11 best places to retire overseas for affordable and efficient healthcare and 17 countries with universal healthcare in 2017
Monkey Business Images/Shutterstock.com
Disclosure: No positions. 15 largest hospitals and health systems in the world is originally published on Insider Monkey.