American Heart Association Warns Health Care Affordability Reaches Crisis Level, Outlines Principles for Reform
The American Heart Association's new Presidential Advisory declares U.S. health care affordability a crisis, citing nearly $5 trillion in annual spending and proposing five core principles to guide policy changes.
The American Heart Association issued a Presidential Advisory on April 30 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 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 Heart Association, 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. Additionally, a survey from political pollster McLaughlin & Associates found 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 warns that rising costs are impacting patients, families, employers, clinicians, and communities nationwide.
The advisory identifies 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.
To guide policymakers and stakeholders, the Heart Association outlines five core principles: 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 public health infrastructure while 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 is based on extensive research and listening sessions with stakeholders, including patients, clinicians, payer representatives, employer representatives, health system leaders, and public health experts. 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.