The American Heart Association released a Presidential Advisory today warning that health care affordability in the United States has reached crisis levels, with total health care spending approaching $5 trillion annually and projected to consume 20% of the nation's gross domestic product within the next decade. The advisory, published in the journal Circulation, details how rising costs threaten the long-term sustainability of the health care system and jeopardize patients' access to care.
According to the advisory, health care costs related to cardiovascular disease are expected to quadruple by 2050. A recent Gallup survey found that people across the country are worried about accessing and affording health care, while a poll from McLaughlin & Associates indicated that more than half (51%) of voters say health insurance is their top health concern, followed by hospital bills (11%) and the cost of medicines (10%).
“Health care affordability is one of the defining challenges of our time,” said Dhruv S. Kazi, M.D., M.S., American Heart Association volunteer and writing committee chair, director of the Cardiac Critical Care Unit at Beth Israel Deaconess Medical Center and Associate Professor at Harvard Medical School. “This advisory outlines core guiding principles for action to ensure everyone in this country has access to the care they need and the health care system is sustainable for generations to come.”
Rising costs have real-world consequences, including forcing patients to delay or forgo care, which worsens health outcomes and contributes to financial hardship and medical debt. Medical debt, a uniquely American problem among high-income countries, is a leading cause of personal bankruptcy. The advisory identifies a complex set of interconnected drivers behind rising health care costs, including high prices for treatments and services, administrative complexity, underinvestment in prevention and public health, demographic shifts, and cost shifting to patients.
The Heart Association suggests that affordability cannot be addressed through cuts alone; strategic investments in the health care workforce, infrastructure, primary care, data, and public health are also necessary to improve outcomes while controlling long-term costs. The advisory outlines five core principles to guide policymakers and stakeholders toward a more affordable and sustainable health care system: access to high-quality care without financial hardship; minimal or no cost-sharing for high-value, cost-effective care, including preventive services; shared accountability across the health care ecosystem for advancing a more efficient, transparent, and cost-conscious system; strategic investments in the health care workforce, infrastructure, and data; and strengthening the public health infrastructure and addressing health inequities.
“We at the American Heart Association believe everyone deserves access to quality health care without financial hardship,” said Nancy Brown, chief executive officer of the American Heart Association. “Affordability is not just an economic issue – it is a health issue that directly affects lives. By laying out clear, evidence-based principles for action, we are doubling down on our commitment to advance policies and solutions that improve access to care, strengthen prevention and build a more sustainable health care system.”
The advisory was created by a volunteer writing group of experts on behalf of the Heart Association. More than 8 in 10 (82%) U.S. adults say they are confident in the American Heart Association to provide trustworthy information related to public health, according to a recent Annenberg Policy Center poll. The Association ranked second only to an individual's personal health care provider. The full advisory, titled "Health Care Affordability in the United States, From Crisis to Action," is available on the American Heart Association's website. Additional resources, including a video interview with Dr. Kazi, are available on the release link.
