Sina Chehrazi , 2025-06-25 14:36:00
Every year, nearly 530,000 Americans go bankrupt because of medical debt. That’s roughly the population of Atlanta city proper. Even worse, we spend more on healthcare than any other country, and still end up with poorer outcomes. The U.S. consistently lags behind other developed nations across key health metrics.
These are only a few signs of how dysfunctional our healthcare system has become. Before we can talk about fixing it, we need to be more honest about what we’re up against. Obsessing about the problem is usually the first step to solving it.
Across the system, data fragmentation and a lack of competition collide, making it nearly impossible for consumers to understand or use their health insurance effectively. At the employer level, even with a growing wave of AI-powered solutions, most benefits still feel impersonal and disconnected. Costs keep rising, and employees are left to navigate an expensive, confusing maze that doesn’t understand them and doesn’t work in their favor.
The benefits industry broke itself.
Long ago, things were simple: you had a pension and a single health plan arranged through your employer, often with someone walking you through it in person from a truck in the parking lot. Then came a surge of specialist benefits companies that offered more specialized business lines. Over time, they started spinning off business units and narrowing their focus to core services.
Fast forward to today and we’re drowning in thousands (13,000+, in fact) of point solutions. Medical, dental, vision, accident, critical illness, disability, pet insurance, identity theft coverage: they have all become pseudo-point solutions. It’s a maze of disconnected services that rarely talk to each other and barely make sense to the people who need them.
Imagine an assembly line where every machine runs on a different operating system and no one talks to the person next to them. That’s our benefits system. Employers don’t fully understand their workforces. Brokers don’t fully understand employers. Everyone is pitching products in isolation, with no clear sense of who they’re helping or how it all fits together.
The result is hundreds of billions of dollars in waste. Most employees have no idea how much their benefits actually cost. Some don’t even know what services they have access to. In many cases, they end up paying more with insurance than they would without it, since hospitals can charge employer health plans up to 254 percent more for the same services. And because people don’t trust or understand the benefits they’re offered, they’re not motivated to share the personal data that would actually make their benefits more useful.
And the waste keeps compounding. As premiums rise year after year, employers assume their teams should feel lucky to have coverage at all. But from the employee’s perspective, it often feels like they’re paying more and getting less. The “buyside” is operating in the dark.
Meanwhile, some players profit from the chaos. Opaque pricing for care and prescriptions helps large incumbents protect their margins while benefitting from transparency. Even when regulations try to force transparency, the penalties are hogwash. A thousand dollars a day means nothing to billion-dollar companies. So they keep hiding the ball, and the system stays broken.
We need to strip the system back to something simpler. People should be able to actually use the benefits they are paying for. And the companies providing those benefits, whether insurers, providers, employers, or brokers, should actually understand who they are serving. That kind of clarity is not optional. It is the foundation of trust, and right now, it is clear that as a society we do not have it.
Not everyone will win. That’s the point.
There are two changes that could transform the entire system.
First, we need real competition in certain areas. Second, we need to connect the most important data everywhere in one place. If we can do those two things, the entire market improves. Not everyone will win, but the good products, the good distributors and the good platforms will rise to the top.
- Direct competition: In most regions, employers and individuals only have a handful of health plans to choose from. Three, maybe four. The lack of meaningful competition limits quality and innovation and allows health plans to do the bare minimum. Looking ahead, we don’t need more companies offering “different” solutions for the sake of being different. We need more companies that do the same thing for the same populations. True competition creates motivation to develop higher-value services, more robust networks and more innovative payment models.
- Connected data: Healthcare should work more like your phone or your favorite apps, with everything in one place, tailored to you. That only happens when people trust a platform enough to share their information. In return, they need to get real value. Think personalized recommendations, automatic insurance checks, smarter scheduling. Once that trust loop starts, it builds. People share more, they get more back, and eventually the system understands them without needing to ask.
Getting there will take more than articles. Health systems need to make interoperability a priority, not a side project. Insurers must deliver real transparency, not just check the compliance box. Employers should stop piling on point solutions and start demanding integrated platforms. And tech companies have to earn trust by delivering transparent value from day one.
This is what better looks like
The payoff of these changes will be significant. Streamlined administration will reduce overhead costs for health systems. Health plans can deploy more accurate pricing models and reduce claim volatility. Employers could see higher ROI on benefit services through higher utilization. Most importantly, employees and individuals would see cost savings, improved navigation, and better outcomes. It will be an actual capitalist marketplace.
Reaching this future state will look and feel a lot like how our 401Ks are managed: by experts in the background, with minimal attention required. And our benefits services will act through an AI-driven assistant who works behind the scenes to book a dental cleaning and confirm insurance coverage before care.
We are not that far off. But to get there, we need to stop building more noise and start rebuilding trust. Everyone deserves a system that works in their favor, not against them.
Photo: crazydiva, Getty Images
Sina Chehrazi is the Founder and CEO of Nayya, a pioneering healthtech and FinTech company transforming how Americans choose and use their benefits. Raised in a family of healthcare professionals, Chehrazi witnessed firsthand the systemic complexities patients face, inspiring him to pursue degrees in business and law at Georgetown University. His early career in data-driven startups and his legal expertise fueled his mission to simplify the healthcare experience.
In 2019, Chehrazi launched Nayya to bring clarity and personalization to benefits enrollment and utilization. Leveraging AI and over 3 billion data points, Nayya delivers tailored recommendations that empower employees to make informed decisions, enhancing their health outcomes and financial well-being. Under Chehrazi’s leadership, Nayya has secured over $130 million in funding and established partnerships with major employers, brokers, and carriers.
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