The United States spends more on health care than any other country, but that spending does not lead to better access, greater affordability, or healthier lives.

A new Commonwealth Fund report compares the U.S. health care coverage system with those in 19 other wealthy countries. Eighteen of those countries guarantee health coverage for all residents. The 19th, Mexico, has a goal of achieving universal coverage by 2027. Because the U.S. does not guarantee coverage, about 27 million people – and rising – are left without health insurance.

Compared to these other countries, Americans face higher out-of-pocket costs and are more likely to delay care, skip medications, or take less medication than prescribed because they cannot afford it. The U.S. has fewer primary care doctors than any of the other countries studied, and about one-third of Americans do not have a regular place to go for general care.



Despite spending far more, the U.S. has the 3rd lowest life expectancy, 2nd worst rate of avoidable deaths, and the highest maternal mortality rate among the countries studied. These outcomes are even worse for some people as a result of their race, income, gender, or where they live.

The high cost of U.S. health care is not just a number that shows how much the country spends. It affects real people, who feel those costs directly through premiums, deductibles, and other out-of-pocket expenses they must pay each year. As health care becomes more expensive, its costs can compete with basic needs such as food, clothing, and housing.

According to KFF’s 2025 Employer Health Benefits Survey, family premiums averaged nearly $27,000, with workers contributing about $6,850. Workers with employer-sponsored health insurance paid an average deductible of $1,886 for single coverage in 2025.

For people who have access to them, Health Savings Accounts (HSAs), Flexible Spending Accounts (FSAs), and Health Reimbursement Arrangements (HRAs) can help make many health care expenses more manageable. Typically, the money contributed within these programs may be used for deductibles, copays, prescriptions, dental and vision care, and other qualified expenses, including over-the-counter medications, birth control, and feminine hygiene products.



These special savings accounts cannot solve the larger problem of all the high health care costs, and they are not available to everyone. However, they may help eligible individuals and families prepare for expenses throughout the year, while making their health care dollars go further.

Health Care Coverage Literacy Spotlight

Health care coverage in the U.S. is complicated. There are multiple coverage programs, all of which have different rules, costs, benefits, and enrollment requirements, making it hard to figure out where to even begin.

The Asclepius Initiative’s (TAI’s) free resources review the basics of the U.S. system in plain language and explain why having coverage matters.

• What Is Health Care Coverage? – Why health care coverage exists and how having it helps people get care and protects them from uncontrolled high medical costs.

• A Simple Overview of Health Care Coverage - An introduction to the main types of coverage and the ways in which people must qualify and enroll, instead of being covered automatically.

• Why Have Health Care Coverage - Why having coverage matters and how going without it can lead to delayed care and medical bills that can lead to medical debt and bankruptcy.



• What to Consider When Choosing a Plan - Important factors to review before enrolling, including your household’s health care needs, monthly premiums, out-of-pocket costs, provider networks, covered services, and enrollment deadlines.

Together, these resources provide a way to feel more confident and informed about health care coverage, including why it is needed and what to consider when reviewing available options.

Save the date! Give for Good Louisville returns on Thursday, September 10th, and TAI is excited to take part for the fourth time.



This city-wide day of giving brings the Louisville community together to support local nonprofits and the work they do every day. We hope you will mark your calendar and support TAI on September 10th.

Follow The Asclepius Initiative on Facebook, Instagram, LinkedIn, and BlueSky to stay informed about developments in health care coverage, education, and reform. We share tips to help you navigate your health care coverage, updates on our work, and opportunities to get involved in creating a healthier future for Kentuckians. Don’t miss out – connect with us today!

The Asclepius Initiative is part of Kroger’s Community Rewards program. Select TAI as the charity of choice and a portion of your receipt will be donated to TAI each time your Kroger Plus Card is used. Signing up is quick and only has to be done once.

1. Go to KrogerCommunityRewards.com

2. Sign into using current login information or the number on the back of the card

3. Select TAI as the organization: search for us by name or by using our code, DG163

Help us continue to provide you with relevant and up-to-date health care coverage information.