The hidden cost of healthcare: When affording care means putting life on hold

A recent West Health-Gallup survey found that one-third of American adults — roughly 82 million people — are making quiet, daily tradeoffs in order to afford healthcare. One in ten are skipping meals or driving less to save on gas, while one in five are postponing larger ambitions, like changing jobs.

The numbers seem small, and the consequences seem subtle at first. But when those tradeoffs extend to major life milestones, like buying a home (14% report delaying), or expanding a family (6%), they take on a different weight. These are not traditionally considered healthcare outcomes, and yet they are increasingly shaped by healthcare costs.

For employers, who provide healthcare coverage for half of all Americans, this shift is easy to miss, but it's too expensive to ignore. When healthcare becomes difficult to afford, the cost of care doesn't disappear from the balance sheet at the end of the year. These costs resurface elsewhere. Care is delayed, sometimes indefinitely, missing opportunities to address chronic conditions and allowing manageable conditions to progress into more serious and costly ones, with serious impacts on a patient's health.

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At the same time, the strain of mounting costs shows up at work: in distraction, absenteeism, and lower engagement. A recent poll found that health care costs rank as a top financial worry for adults and their families. That financial stress is difficult to leave at home, with those concerns routinely distracting employees during the workday. About one-third of employees report that financial stress affects their productivity, and over half of those employees report spending three or more hours on the job each week thinking about or dealing with issues related to their personal finances.

In the wake of these pressures, the instinct for many employers has been to offer more: more programs, more point solutions, more expansive benefits. Yet even as investment in healthcare benefit solutions rises, so does the sense that the system remains difficult to use. Access, it turns out, is not simply a question of coverage. It is also a question of time and clarity.

Care that is technically available but difficult to navigate might as well be out of reach. When getting care requires coordination, time, and a series of uncertain decisions, many people choose to wait…or forgo it entirely. The complexity of American healthcare leaves many people unsure how to tap into available resources, making navigation to care difficult and time-consuming. When faced with duplicative options — like multiple telehealth apps offered as healthcare benefits — many Americans are left confused about their choices, unsure how best to tap into their benefits, and overwhelmed by their attempts to navigate the system. The result is often forgoing needed preventive or ongoing care due to the muddled, overcomplicated system.

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Changing this behavior requires more than lowering the financial barrier, although that remains essential. It requires reducing the cognitive and logistical burden, too. When care is easy to access, the path is clear, and the next step is obvious, people engage earlier. Conditions are addressed sooner. Outcomes improve, and the downstream costs that employers ultimately bear begin to decline.

The challenge, then, is not simply to provide more care, but to make care usable. In a system defined by complexity, the organizations that create clarity will be the ones that change how care is delivered AND whether it is sought at all. People should be able to have their healthcare — and use it, too.