The Role of New Hampshire in Leading Change in Health Costs
The cost of healthcare in the United States has reached a breaking point, with more Americans than ever delaying medical care due to financial concerns. According to a Gallup poll, 38% of Americans postponed medical treatment in 2022 due to cost—a sharp increase from 26% in 2021 and the highest rate since Gallup began tracking this data in 2001. These delays often involve serious health conditions, compounding the challenges for families already navigating the complex labyrinth of hospital bills, insurance disputes, and out-of-pocket expenses.
These statistics are not just numbers—they represent real struggles faced by our families, neighbors, and businesses. In New Hampshire, rising healthcare costs not only strain household budgets but also threaten the sustainability of our healthcare system and the well-being of our communities. It’s clear that the time for dialogue and collaborative action is now.
The Global and Local Challenge
Healthcare costs are a crisis, with inequities in access and financial burdens felt at every level—individual, household, and government. Globally, healthcare spending now represents approximately 11% of GDP and is projected to outpace GDP growth over the next 15 years. Locally, New Hampshire families feel the squeeze as rising premiums and deductibles force tough choices, from delaying care to forgoing essential treatments altogether. Just last year, more than 3 in 5 (69%) of New Hampshire residents surveyed reported they had delayed or avoided seeking health care due to cost.
In the U.S., patients bear more out-of-pocket costs than anywhere else in the world. Our fragmented care delivery system—marked by inefficiencies, workforce shortages, and underinvestment in preventive care—further drives up expenses without necessarily improving patient outcomes. In fact, American health outcomes generally lag behind those of other high-income countries, despite significantly higher healthcare spending
These inefficiencies undermine the promise of accessible and equitable healthcare. The U.S. ranks last on four of five health outcome measures internationally. Life expectancy is 4 years below the average, and the U.S. has the highest rates of preventable deaths for people under 75.
While many health care and health finance issues are governed at the federal level, there is much we can do to develop solutions that work for our state. In New Hampshire, we can bring together healthcare consumers, providers, policymakers, and business leaders to develop practical solutions that lower costs while improving access and outcomes. By fostering open discussions, sharing innovative ideas, and prioritizing the voices of those directly affected by rising costs, we can create a more equitable healthcare system that benefits everyone.
Some Key Issues Driving Healthcare Costs
Delayed Care: The sharp rise in delayed medical treatments reflects the financial barriers many families face. When people delay care, particularly for serious conditions, they often require more intensive—and expensive—treatment later.
Workforce Shortages: A lack of healthcare professionals, especially in primary care, contributes to delayed care, higher costs and reduced access. It is currently estimated that New Hampshire needs about 40,000 new workers into the system. This is exacerbated by high educational debt that can drive new providers toward more lucrative specialties instead of general practice.
Underinvestment in Prevention: Preventive care reduces long-term costs and improves outcomes, yet it remains underfunded. Shifting focus from reactive treatments to preventive care could save lives and money.
Administrative Costs and Inefficient Systems: Administrative inefficiency is a major factor driving up costs. The U.S. ranks second to last globally in administrative efficiency, with a complex web of billing systems and insurance disputes that bog down providers and patients alike. And, hospital mergers by limiting competition, increasing administrative complexity, and prioritizing profit over patient care, can worsen healthcare inefficiencies, driving up costs and compromising the quality of care patients receive.
Unnecessary Spending: Fragmented care, poor data governance, and underinvestment in prevention lead to unnecessary tests, procedures, and expenditures that fail to improve patient outcomes.
Some Key Areas for Change
Focusing on Preventive/Primary Care: Investing in preventive measures—like screenings, nutrition, and stress management—can reduce costly interventions later.
Improving Workforce Support: Programs like debt forgiveness and stipends for primary care physicians can address workforce shortages and improve access to care.
Enhancing Transparency: Clearer pricing and billing practices can empower patients and make the healthcare system more navigable.
Addressing Unnecessary Spending: Evidence-based guidelines and reforming duplicative and unnecessary practices can eliminate wasteful expenditures.
Streamlining Administrative Processes: Simplifying billing and insurance systems can reduce inefficiencies and ease financial burdens for patients.
The Role of New Hampshire in Leading Change
The New Hampshire Health Cost Initiative is committed to advancing this public conversation, bringing together healthcare consumers, providers, business owners, and community leaders to address these challenges head-on. By connecting leaders and ideas, we are developing resources that equip Granite Staters with the knowledge and tools to advocate for practical solutions that reduce healthcare costs and improve access for all. By working together and maintaining a focus on trust, transparency, and collaboration, New Hampshire has the opportunity to create a healthcare system that strengthens our communities, supports our businesses, and ensures better health outcomes for everyone.
A new opportunity to shape the conversation has begun —and with it, the chance to make lasting change. Let’s make healthcare in New Hampshire more affordable, accessible, and equitable for every Granite Stater.