Health Care Cost Crisis and What to Do
The health care cost crisis has officially arrived!
For years, experts warned that rising costs were unsustainable—and today, that warning has become reality. The U.S. health care system is reaching a breaking point, and employers and consumers are feeling it firsthand.
The Contradiction We Can’t Ignore
We spend nearly $5 trillion a year on health care—almost 18% of the U.S. economy—yet our health outcomes still lag behind other developed nations. Despite this massive investment, consumers aren’t getting healthier, and they certainly aren’t spending less.
The system isn’t just expensive… it’s failing to deliver value.
Why Costs Keep Climbing
Even as insurers like Blue Cross Blue Shield spend 87 cents of every premium dollar on members’ medical bills (above the required 80 cents), costs continue to rise—especially in pharmacy:
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Specialty medications like Ozempic, Enbrel, and Tremfya carry huge price tags.
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Higher usage, including ongoing monthly injections, increases overall spending.
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Pharmacy costs remain a smaller share of premiums, but their rapid growth is one of the biggest threats to affordability.
What’s Being Done
Blue Cross and other industry leaders are taking action to help regain control, including:
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Driving more value out of every provider visit
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Prioritizing preventive care to reduce high-cost chronic conditions
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Expanding telehealth for convenience and cost savings
But real change also requires informed consumers—and that’s where you can make a meaningful impact.
What You Can Do Right Now
Welcome to consumer-driven health care. You have more power than you might realize. Here are practical steps to manage your health care spending:
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Compare prices before procedures—an MRI can vary by hundreds of dollars.
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Use telehealth for routine needs—it’s fast, convenient, and typically lower cost.
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Stay proactive with preventive care.
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Use GoodRx or prescription assistance programs to avoid overpaying.
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Explore lower-cost GLP-1 options through Hims & Hers or TrumpRX (approx. $199—delivered, no prescription needed).
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Stay in-network—always confirm before treatment.
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Ask for costs upfront, especially for major services.
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Consider paying cash at a negotiated rate—it can sometimes be cheaper than using insurance.
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Treat your HSA as a medical IRA—the average retiree faces $250,000 in out-of-pocket medical expenses.
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Connect with your Smart Choices Health Benefit Coach—we help you understand your plan and navigate costs effectively.
The Bottom Line
Health care costs are rising for everyone—but together, we can make smarter decisions, reduce unnecessary spending, and demand more value from the system.
Smart Choices Health is here to help you navigate these challenges with confidence.
If you’d like a personalized strategy or need help reviewing your current plan, simply reply to this email—we’re here to support you.
Thank you,
Barbara Saxton