A record 23% of Americans believe the United States healthcare system is “in a state of crisis” and 47% think it has “major problems,” according to a recent poll from the West Health-Gallup Center on Healthcare in America. The poll also revealed that a record 29% of Americans see “cost” as the most urgent health problem facing the US. These perceptions are interconnected, as experts note the systemic issues with healthcare insurance, rapidly rising drug prices, and challenges within current health administration all contribute to the crisis sentiment.
The Cost Crisis and Its Ripple Effects
Healthcare costs directly affect health outcomes and individual wellbeing, not merely as an abstract policy issue but as a direct hit to Americans’ wallets. As the population ages, healthcare expenses rise further; most money spent in the US healthcare system is on people 55 or older. The cost burden leads Americans to skip necessary treatments: nationally, one in five adults reported a household member unable to afford a prescription medication, but this varied by region—three times higher in Mississippi than in Iowa. Thirty percent of US adults said a family member had skipped a medical treatment due to high costs, with nearly half of Mississippi respondents reporting this experience compared to one in five in the best-performing states.
Mental Health and Healthcare Affordability: A Feedback Loop
Mental health care has become increasingly difficult to access due to cost barriers. Adults who experienced 14 or more mentally unhealthy days in a month were more likely to be unable to afford to go to the doctor, creating what David Radley, senior scientist for health system tracking at the Commonwealth Fund, described as a “feedback loop.” Mental health services are often considered a “carve-out” in insurance plans, requiring out-of-pocket payment with uncertain reimbursement, unlike preventive physical health care covered by the Affordable Care Act.
Rethinking Mental Health Integration
Dr. Lisa Rosenthal, a psychiatry professor at Northwestern University, argues that the disconnect between physical and mental health perpetuates the access problem. She noted that including mental health screening in primary care settings—similar to routine blood pressure and cholesterol checks—could improve outcomes and reduce overall healthcare costs. “We have chosen to not pay for psychiatric treatments. We have chosen to not make them accessible to the vast majority of the population,” Rosenthal said, suggesting that the shortage of accessible mental health services is a policy choice rather than an inevitable constraint.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.theguardian.com/us-news/2025/dec/31/healthcare-americans-poll-data-insurance