America's $220 Billion Medical Debt Problem

How small healthcare costs can create much larger healthcare consequences.

Most healthcare conversations begin with access.
Do people have coverage?
Can they see a provider?
Can they get into the system?
Those questions matter.

But an equally important question receives far less attention:
What happens after care begins?

Because for millions of Americans, the challenge is no longer gaining access to healthcare.

The challenge is successfully carrying care through to completion.
And the numbers suggest this challenge is larger than many realize.

America's medical debt burden is estimated at approximately $220 billion, making medical debt one of the largest sources of financial strain facing households today.

At the same time, healthcare affordability remains a significant concern even among insured individuals. National surveys continue to find that roughly one in four adults report difficulty affording healthcare or prescription medications.

Research published in JAMA Network Open has also shown that prescription abandonment rises significantly as out-of-pocket costs increase. In some cases, patients never begin treatment despite having access to a prescribed therapy.

These statistics point toward an important reality:
Healthcare access and healthcare completion are not always the same thing.
A patient can have insurance.
A treatment plan.
A referral.
A prescription.
An appointment.
And still encounter barriers that interrupt care.

When that happens, the consequences often extend beyond the individual healthcare encounter.
Conditions remain unmanaged.
Treatment plans are delayed.
Additional healthcare services may become necessary.

What began as a manageable issue can become a more complex and costly healthcare event.

As conditions progress, patients may require additional healthcare services, including urgent care visits, emergency department visits, hospitalization, or more intensive treatment interventions.

When patients eventually return to the healthcare system, they often require more complex care than was originally needed.

The consequences extend beyond the patient.
What This Means for Families
Healthcare challenges rarely affect only one person.

Within military and veteran families especially, healthcare decisions often affect entire households.
When affordability interrupts care:

• Treatment decisions may be postponed
• Health conditions may worsen over time
• Financial pressure can compound
• Family stability may be affected

The impact is often broader than a single medical bill.
Why This Matters in Military Healthcare

This challenge exists within military healthcare as well.
The Defense Health Agency identifies retail network pharmacies as one of the primary access points for TRICARE beneficiaries.

For many patients, the final step in a treatment plan occurs not in a hospital or clinic.
It occurs at the pharmacy counter.
Coverage helps reduce the financial burden.

It does not eliminate it entirely.
Care is prescribed.
Cost is introduced.
Completion becomes uncertain.

The gap between access and completion is where affordability barriers often emerge.
What We Are Seeing in Practice

At the Medic Now Foundation, this pattern is not merely theoretical.
Through the Healthcare Cost Assistance Program (HCAP), support is most frequently used in small, targeted amounts at routine healthcare touchpoints, particularly pharmacies and other healthcare-related expenses.

The observation is straightforward:
Many healthcare disruptions are not caused by the absence of care.
They occur after care has already been authorized, prescribed, or made available.

In many cases, relatively small out-of-pocket expenses become the barrier that prevents the next step from happening.

When those barriers are removed, care can continue.
The Final Mile of Care

The Medic Now Foundation's Healthcare Cost Assistance Program focuses on what might best be described as the final mile of care.

The program does not replace healthcare systems, insurance coverage, or clinical providers.
Instead, it provides targeted support designed to help military-connected individuals complete prescribed care when affordability barriers create disruption risk.

Because healthcare success is not measured solely by whether care is available.
It is measured by whether care is completed.

America's $220 billion medical debt problem is ultimately more than a financial issue.

It is a reminder that access alone does not guarantee completion.
And for many patients, the final mile of care remains one of the most important challenges in healthcare today.


Sources

• Peterson-KFF Health System Tracker
• JAMA Network Open
• Centers for Disease Control and Prevention (CDC)
• Agency for Healthcare Research and Quality (AHRQ)
• Defense Health Agency (DHA)
• TRICARE