American Heart Association Warns Health Care Affordability Has Reached Crisis Levels

The American Heart Association today released a Presidential Advisory 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 association’s journal Circulation, details how rising costs threaten the long-term sustainability of the health care system and jeopardize patients’ access to care, putting the health of families and communities nationwide at risk.

According to the advisory, health care costs related to cardiovascular disease are projected to quadruple by 2050. A recent public opinion survey from Gallup indicated that people across the country are worried about being able to access and afford health care. Another survey from political pollster McLaughlin & Associates found that more than half (51%) of voters say health insurance is their top health concern, with other top worries including 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 in Boston, MA. “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 warns that rising costs are impacting patients, families, employers, clinicians and communities nationwide.

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 also are necessary to improve outcomes while controlling long-term costs.

The Heart Association 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 health care 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 Heart Association encourages and challenges policymakers, health care leaders and stakeholders to use this advisory as a roadmap for meaningful action across all sectors to address the nation’s health care affordability crisis. The association emphasizes that reducing financial barriers to evidence-based, cost-effective care, prioritizing prevention and investing strategically in the health care workforce, infrastructure and public health are necessary to address health care affordability, which is essential to improving health outcomes and ensuring a more sustainable health care system for future generations.

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