While the headlines focus on tariffs and interest rates, there are quieter crises in hospitals, clinics and homes nationwide. Americans are delaying care, skipping drugs and accumulating damage to medical debt. In many cases, health care costs force people to choose between health and basic needs.
Consider a school teacher who skips the year's body due to the $5,000 deduction. To afford single parents' insulin. Uber drivers waiting for the emergency room are the only option. These are not rare or anecdotes; they are very common, everyday experiences.
Health should not be a luxury, but we have arrived at a temporary, and staying healthy is increasingly at the expense of housing or feeding. It is not limited to one population or region. This is a national warning sign and is not sustainable.
The system not only broke – it has been missed
The problem is not just that health care is expensive. This is unpredictable, inefficient, and structurally inconsistent with the needs of the patient. High-value plans underinvest millions of investment. The prevailing fee payment model will reward the amount exceeds the prevention value and procedures.
Statistics are very clear:
- More than 91 million Americans (more than one-third of the population) do not have access to quality health care.
- In 2024 alone, Americans borrowed $74 billion to pay for medical expenses.
- Now, medical debt totals at least $220 billion, affecting one of the twelve adults and remains the main cause of personal bankruptcy.
- Nearly one-third of Americans are very concerned about a major medical incident that could lead to financial damage.
- Two-thirds cannot meet an emergency of $1,000, while the average hospitalization cost is $3,000 every day.
These financial stressors are not theoretical. They directly lead to deferred care and other trade-offs: 38% of adults delay medical or medication due to costs. 42% of them said their condition had worsened. One-third of people report that they need to reduce their food to pay for medical expenses.
Meanwhile, health care costs continue to outweigh the prices of essentials like inflation, wages, and groceries and utilities, widening the gap between affordability and access.
Recent legislation could deepen this gap. The “one big beauty bill” closed by the House could cause 11 million people to lose coverage in the next decade, according to the Congressional Budget Office. While aimed at expanding employer flexibility, the bill could limit affordable care options and increase financial pressure on vulnerable populations.
Better model: People overprofit
Start with reducing costs, improving results and putting people back into the system-centered care model, there is a viable path forward. Not only incremental repair, but also rethinking how care is provided.
Advanced Primary Care (APC) is sometimes called value-based primary care, often referred to as employee benefits – an example of the fundamental changes we need. It's about reconstruction foundations: longer, non-recreational visits; same or second day visits; comprehensive support from nutritionists, mental health professionals and pharmacists; and focus on prevention procedures. By removing cost barriers and administrative frictions, APC readjusts incentives around what matters most: Keeping people healthy. It can be proven that everyone benefits when the care team is empowered and truly supported.
Direct Primary Care (DPC) is another example. For affordable monthly fees, individuals can access their primary care team without limit. No surprise bills or deductible barriers. Patients can get help as early as possible, rather than wait until the condition worsens, but often get help. The result is: 40% fewer emergency visits, 53% lower emergency spending, and much less financial pressure.
Community health centers can also play a vital role. These facilities serve low-income and underserved populations, providing comprehensive, sliding scale care including behavioral health, dental and social services. By meeting patients, they help eliminate common access barriers such as insurance status, transportation and language.
These are not hypothetical fixes. Almost every state has over 2400 DPC practices. The APC market is growing, and community health centers have long been the lifeline for vulnerable people.
Such an option is not a silver bullet, but it does make care more accessible, predictable and affordable. They are a step towards a more sustainable system where care is not determined by deductible or bank accounts and staying healthy does not mean risking financial damage.
Retrieve the most important
As policy experts point out, the increase in the number of people unable to pay for health care is a disturbing trend that may continue or increase. But that's not that.
Transformation in our healthcare system can now begin with employers adopting a value-based care model, demanding better access to communities, and policy makers who challenge the status quo.
If we want a healthier and fairer future, we must stop bankruptcy against Americans so that they can live. It’s time to go beyond partisan deadlock and economic conversation points and focus on what’s most important: building a sustainable healthcare system that revolves around people rather than profit margins.
Photo: KLH49, Getty Images
Jordan Taradash is the CEO of pepeopeone Health, leading the next generation of primary care by seamlessly integrating treatment and prevention to reduce costs and improve health. He holds a Bachelor of Finance from Penn State University and an MPH from Epidemiology at the University of Pittsburgh.
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