Por Renan Filho · 2026-09-25Brandi Glanville, the 51-year-old reality television personality and former model, disclosed this week that she has been forced to liquidate her entire 401(k) retirement account after spending “hundreds of thousands of dollars” on medical bills. In a candid interview on the Jeff Lewis Has Issues podcast, Glanville said she drained the account — which she had built up over years of work — to pay for treatments related to a chronic health condition that has left her face visibly swollen and caused significant pain.
The situation Glanville describes is not isolated. It is the predictable outcome of a healthcare system where the patient is the last person in the room with any control over price. According to Glanville, her medical expenses have included multiple specialist visits, imaging scans, prescription drugs, and at least one surgical procedure. She said she does not have a clear diagnosis, which has meant repeated rounds of testing with no end in sight. “I have no retirement now,” she said. “It’s gone. It all went to doctors.”
Why This Matters: The 401(k) Is Not a Healthcare Slush Fund
Glanville’s case illustrates a broader crisis that free-market economists have warned about for decades. When the government subsidizes demand through tax-advantaged health savings accounts — but simultaneously allows states to enforce certificate-of-need laws, scope-of-practice restrictions, and insurance mandates — the result is a system where prices are opaque, insurers dictate terms, and patients are left holding the bag.
Under a truly free market, healthcare prices would be transparent and competitive, much like cosmetic surgery or Lasik eye surgery, both of which have seen prices fall in real terms over the past 20 years because they are largely paid out-of-pocket. But for the vast majority of medical services, a third-party payer — either the government or an insurance company — stands between the patient and the provider. This severs the price signal. When patients don’t see the bill, providers have no incentive to compete on cost, and insurers have every incentive to raise premiums while denying claims.
Glanville’s 401(k) was meant for retirement, not for a broken healthcare system. The fact that she had to tap it at all suggests that even for someone with her income and presumably decent insurance, the system is failing.
FORTIS Analysis: The Price of Ignoring Market Signals
The liberal-conservative view of healthcare holds that the solution is not more government intervention — it’s less. We should eliminate the tax exclusion for employer-sponsored health insurance, which currently distorts the market by encouraging people to buy gold-plated plans that drive up costs for everyone. We should allow the interstate sale of health insurance, breaking up state-level insurance monopolies that prevent competition. We should repeal certificate-of-need laws that limit the supply of hospitals and clinics. And we should require price transparency by law — not just a vague mandate, but actual, enforceable disclosure of prices before any non-emergency procedure.
Instead, bipartisan policy in Washington has moved in the opposite direction. The so-called “surprise billing” law passed in 2020 was an improvement, but it still allows insurance companies and providers to arbitrate prices behind closed doors, keeping patients in the dark. Meanwhile, Medicare and Medicaid continue to distort prices through administered rate-setting, which shifts costs onto private payers — the same private payers who then drain their retirement accounts to cover their share.
Glanville’s story is a data point in a much larger trend. According to the Employee Benefit Research Institute, 28% of workers with a 401(k) have taken a loan or hardship withdrawal from their account, and medical expenses are the single most common reason cited. That means millions of Americans are sacrificing their retirement security for the privilege of being treated in a system that charges them more than any other developed country — while delivering worse outcomes on many metrics, including maternal mortality, chronic disease management, and wait times.
Counterpoint: The ‘Insurance Works’ Argument
To be fair, defenders of the current system — including many on the political left — argue that the answer is to expand government insurance further, such as through a public option or a single-payer system. They point to countries like Canada and the United Kingdom, where out-of-pocket spending is lower. But these systems come with their own costs: long wait times for specialist care, rationing of high-tech procedures, and a lack of innovation. A 2023 study in the Journal of Health Economics found that cancer patients in single-payer systems wait an average of 40 days longer for treatment than patients in the U.S.
Moreover, Glanville’s problem is not a lack of coverage — she has insurance. The problem is that her insurance, like most employer-sponsored plans, comes with high deductibles, co-pays, and out-of-network exclusions that leave her exposed to catastrophic bills. Expanding government insurance would not solve this; it would merely transfer the cost to future taxpayers while continuing to suppress price signals.
**Q: Could Brandi Glanville have avoided draining her 401(k) by choosing a different insurance plan?**
Possibly, but not easily. Employer-sponsored plans typically offer limited choices, and even the most generous plans usually have caps on coverage for certain chronic or undiagnosed conditions. The real solution is to decouple insurance from employment entirely, allowing individuals to buy portable, multi-year plans with high deductibles and health savings accounts that they actually control. Under that model, people like Glanville would have the flexibility to shop for elective procedures with transparent pricing, rather than being forced to use whatever in-network provider the insurance company dictates.
**Q: Is Glanville’s case an argument for single-payer healthcare?**
No. Quite the opposite. Her case shows what happens when insurance companies — not patients — make the financial decisions about care. In a single-payer system, the government would be the sole insurer, meaning that her access to care would depend entirely on political budgeting and bureaucratic gatekeeping. If she had trouble getting a diagnosis under a private insurer, imagine how hard it would be under a system where every MRI and specialist referral has to be approved by a government agency with no competition. The freedom to pay out-of-pocket for faster, better care would be gone.