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The Cost of Getting Sick in America

  • Writer: Brianna Lane
    Brianna Lane
  • Oct 12
  • 4 min read

Getting sick in America isn’t just a health scare- it’s a financial risk. For millions, the scariest part of an illness isn’t the diagnosis, it’s the bill that follows. Even with insurance, medical debt has become one of the most common and crushing forms of personal debt in the country. The United States spends more on healthcare than any other nation (over $4.5 trillion a year, or roughly 17% of GDP) yet affordability and access remain among the worst in the developed world.


A 2022 Kaiser Family Foundation (KFF) analysis estimated that 100 million Americans carry some form of medical or dental debt. That’s nearly 40% of all adults. One in five adults with medical debt say they’ve been contacted by debt collectors, and one in ten report that they’ve declared bankruptcy at least partly because of medical bills. Even people who have health insurance are vulnerable. The Commonwealth Fund found that in 2023, 43% of working-age adults were underinsured, meaning their coverage didn’t protect them from high out-of-pocket costs. For families with high-deductible plans, a single ER visit can trigger thousands in expenses before coverage even begins.


The American healthcare system creates debt by design. Hospitals and clinics can charge vastly different rates for the same service, and patients often have no way to know the price upfront. One hospital in the same city might bill $8,000 for an appendectomy, while another charges $30,000. Insurance doesn’t necessarily bridge that gap. Even when costs are known, they’re often unaffordable. The average deductible for employer-based insurance has more than tripled since 2006, reaching $1,763 per person in 2023. Meanwhile, wages haven’t kept pace, leaving patients to make impossible choices: skip care or go into debt. Surprise billing adds another layer of chaos. Before the 2022 No Surprises Act, patients frequently received five-figure bills for out-of-network doctors they never chose. The law curbed some of that, but loopholes and weak enforcement keep the problem alive.



A JAMA Network study found that medical debt was the leading cause of personal bankruptcy in the U.S., responsible for about two-thirds of all cases. Debt drives families to skip rent, delay education, or ration medication. The mental health impact is just as severe. People burdened by medical debt report higher rates of anxiety, depression, and even physical decline linked to chronic stress. Health researchers call it a “toxic stress loop”: illness leads to debt, debt worsens stress, and stress worsens health. And like most systemic issues, the burden isn’t distributed equally. KFF data shows that Black adults are 50% more likely to have medical debt than white adults, and people in the South, where Medicaid expansion has lagged, carry the heaviest loads. The debt crisis is as much about equity as it is economics.


Fixing medical debt means confronting both the cost of care and the way it’s financed. Expanding price transparency laws could give patients real information before treatment. Though hospitals are technically required to post prices online, only about one in four currently comply meaningfully. Enforcement and standardization could help patients make informed choices. Capping out-of-pocket costs, a model used in parts of Europe and Canada, could stop medical emergencies from becoming financial disasters. Policies like these don’t eliminate private healthcare but ensure that coverage actually protects people. Debt relief programs also have untapped potential. The nonprofit RIP Medical Debt has erased over $10 billion in unpaid bills by purchasing debt portfolios at a fraction of their value. If local and federal governments supported similar models, millions could be freed from financial hardship overnight. And finally, long-term reform has to focus on prevention and equity. Every dollar spent on early care and public health saves multiple dollars in later treatment. Countries that invest in universal or preventive healthcare consistently report lower costs and longer life expectancies- proof that the system doesn’t have to work this way.


Medical debt is more than a financial problem, it’s a reflection of national priorities. A system that bankrupts people for getting sick is one that values profit over public health. Until healthcare is treated as a right rather than a privilege, Americans will continue to live one illness away from financial collapse. The data is clear: we’re spending more to get less. The solution isn’t just to lower costs, it’s to rethink what we owe one another when it comes to care.



 
 
 

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