The Real Cost of the Healthcare System for Women
Updated: May 26, 2026
The Cost of the Healthcare System Nobody Puts in the Budget
You already know this feeling.
You went in with a real concern. You left with a pamphlet, a follow-up appointment three months out, and the particular exhaustion of having explained yourself to someone who had already decided what you had before you finished your sentence.
You didn't imagine that. You didn't overreact. What you experienced has a name — and it has a biology. And it's been happening to women in this healthcare system long enough that most of us have stopped calling it dismissal and started calling it Tuesday.
That's the cost nobody puts in the budget.
What the System Was Designed to Do
In December 2024, Luigi Mangione shot and killed Brian Thompson, the CEO of UnitedHealthcare, outside a Manhattan hotel. The trial is ongoing.
What stopped people wasn't only the shooting. It was the public response. Social media didn't fill with uniform outrage. It filled with stories. Prior authorization denials. Medically necessary care blocked by an algorithm. Physicians spending hours on the phone justifying treatment to reviewers who had never seen the inside of a clinical training program. Patients who died while the appeals process ran its course.
People weren't celebrating violence. They were exhausted. And exhausted people recognized the wound even when they couldn't condone what came from it.
Audre Lorde wrote that your silence will not protect you. Medicine has been silent about this particular wound for a long time. The Mangione case didn't create the anger. It found the anger that was already there — fully formed, waiting for something to make it visible.
Prior authorization exists because the insurance industry discovered it could reduce payouts by requiring physicians to justify care before delivering it. The physician who spent nine years training to recognize patterns across complex, interconnected systems now spends a documented and growing portion of clinical time on the phone with someone whose job is to find a reason to say no. That's not a design flaw. That's the design. The cost being contained isn't the insurance company's. It's yours.
What It Costs Your Body
Here's what that system does when you're inside it — not on paper, but in your body.
Every denied claim is a stressor. Every dismissed symptom is a stressor. Every visit that ends before the real question makes it out of your mouth is a stressor. Chronic stress has a biology. It changes your cortisol rhythm. It disrupts your sleep. It alters how your gut functions, how your immune system responds, and how your brain interprets threat.
If you're in perimenopause, this matters more than it ever did before. The hormonal shifts of the menopause transition lower the buffering capacity your nervous system used to have. The things you tolerated at 38 — the rushed visit, the vague answer, the follow-up appointment that's really just a polite deferral — land differently at 48. Not because you've become more sensitive. Because the buffer is thinner and the load is heavier.
A healthcare system that keeps feeding your nervous system threat instead of safety isn't treating you. It's adding to the load it's supposed to reduce.
That's not a metaphor. That's physiology. And it shows up in your labs, your sleep, your weight, your mood, and the particular frustration of doing everything right and still not feeling like yourself.
Who Pays the Most
Not everyone absorbs this cost equally.
Black women in this system are believed less, treated less aggressively for pain, dismissed faster, and sent home with fewer answers across nearly every category of care the research has studied. The Study of Women's Health Across the Nation has documented for decades that Black women carry longer, more severe menopause symptoms than any other group. That's not biology in isolation. That's biology living inside a system that has consistently decided some bodies are worth less clinical attention than others.
When I wrote in the previous post about the lawsuit against Find A Black Doctor, I was writing about the infrastructure that helps address this gap being actively dismantled. This post is about what that gap costs in bodies. In years of symptoms that could have been managed. In trust that doesn't come back after enough dismissals. In women who stopped going back because the going back cost more than the staying home.
A system that can't explain its worst outcomes and then sues the tools designed to address them isn't working toward health. It's protecting its own operating model.
What Hasn't Changed
The news cycle moved on from the Mangione case. The trial continues. UnitedHealthcare is still UnitedHealthcare. Prior authorizations still kill people through delay. Physicians are still spending hours on the phone justifying care. Women are still leaving appointments with less than what they came in needing.
What changed is that more people said it out loud. That matters — language is the first step toward accountability. But language without structural change is documentation of a wound that keeps being inflicted.
You deserve more than documentation. You deserve care that was built for the body you actually live in.
That's what the rest of this series is about.
Take the Next Step
If the standard care model has left you with more questions than answers, start here. The Color Archetype Quiz takes five minutes and gives you a starting point for understanding how your nervous system is actually wired — and what it needs right now.
Take the Free Color Archetype Quiz → 👇🏽
Sources
Lorde, Audre. The Cancer Journals. 1980.
SWAN — Study of Women's Health Across the Nation. swanstudy.org
Dr. Stacey Denise is a board-certified surgeon transitioned into lifestyle medicine specializing in the menopause transition. She sees patients in California, Georgia, Kentucky, Maryland, Ohio, Texas, and Virginia.
