The data: A record 23% of US adults now believe the nation’s healthcare system is in a state of crisis—the highest level recorded in 30 years, according to West Health-Gallup data.

• 47% of respondents polled in November 2025 believe the US healthcare system has “major problems,” compared with 25% who said its issues are minor.
• The 23% who believe US healthcare is in a state of crisis is a 7 percentage-point increase from last year.

What’s driving the trend: Affordability stands out as consumers’ leading concern with US healthcare.

• 16% say they’re satisfied with the cost of healthcare in the US, the lowest level ever recorded by Gallup.
• Nearly half (44%) of US adults say it’s somewhat or very difficult to afford their healthcare costs, per May 2025 KFF polling.

Why it matters: Many Americans are making dangerous trade-offs, sacrificing their medical needs just to keep up with the cost of care.

• 36% acknowledge they’ve skipped or postponed needed healthcare in the past year due to cost, per KFF’s data. Among these people, nearly 1 in 5 say their healthcare got worse as a result.
• 21% in KFF’s survey say they have not filled a prescription because of the cost.

Implications for the healthcare system: High healthcare costs in the US aren’t new, but more consumers are increasingly feeling the strain. Even people with “good” health insurance are finding themselves paying more out of pocket for their care due to being pushed into high-deductible plans or dealing with coverage restrictions. The outlook worsens as millions of people may face higher insurance costs or lose coverage, depending on Congress’s handling of ACA premium tax credits expiring at year’s end.

The healthcare crisis felt by one-quarter of Americans stems from a for-profit system prioritizing business over patients, forcing many to forgo care. Healthcare providers will likely see less physician loyalty, as some patients become more selective about when they seek care and others shop around to manage higher out-of-pocket costs. Overall, patient behaviors stemming from skipped care and treatment will worsen people’s health and ultimately lead to more costly hospital care, driving up systemwide costs.