Report warns healthcare could consume 20% of GDP by 2033

• U.S. health spending is growing faster than the economy and will reach 20.3% of GDP by 2033.

• Six structural problemsfrom price disparities to chronic diseaseare pushing the system toward crisis.

• Trilliant Health says stakeholders must either enact reform or face government-imposed change.

Health expenditures continue to rise faster than the nations GDP, creating what Trilliant Health calls an unsustainable imbalance. The firms 2025 Trends Shaping the Health Economy Report projects that healthcare will consume more than one-fifth of the economy within eight years.

Medical prices have surged 54.5% since 2009, with negotiated commercial rates for the same inpatient procedure varying by an average of 8.5 times nationwide. Even within the same facility, the price can differ by up to sevenfold depending on the payer.

Americans are living shorter, sicker lives

Despite higher spending than peer nations, Americans are experiencing declining life expectancy and worsening health. Rising mortality rates among adults aged 18 to 44, combined with falling fertility, are shrinking the population covered by employer-based insurance.

The delivery system rewards high-margin specialty care instead of primary care. Primary care visits fell 5.6% last year while behavioral health visits rose 11.4%, marking the first time behavioral health utilization surpassed primary care.

Fraud, waste and abuse remain entrenched

Upcoding is driving costs upward, with high-complexity ER visits increasing from 36.6% to 47.8% of visits between 2018 and 2024. Vertical integration also reshapes incentives, as UnitedHealthcare reportedly pays its own Optum providers more than competing doctors.

Outpatient migration is accelerating, with ambulatory surgery centers now handling more than half of eligible surgeries. At the same time, pharmaceutical therapies such as GLP-1 drugsup 744% since 2018are displacing procedure-based care like bariatric surgery.

Past government programs have produced minimal savings, but Trilliant warns that mounting political pressure could soon drive sweeping reform. Unless employers and providers deliver value for money, policymakers may resort to structural interventions, including price controls.

A system at a crossroads

Everybody says they know about these problems facing our healthcare system, said Allison Oakes, Ph.D., Trilliants chief research officer. But the lack of action by industry stakeholders has allowed them to persist. The choice is whether to implement radical change from the insideor wait for it to be forced from the outside.

Read the full report here: Trilliant Health 2025 Trends Report

Prevention / What consumers can do

Even though this report is focused on systemwide economics, here are some tips for consumers:

• Shop around for care: Even within the same cityor the same hospitalprices for the same procedure can vary by thousands of dollars. Use insurer cost-estimator tools and independent price-transparency platforms before scheduling.

• Invest in prevention: Schedule regular primary care and preventive screenings. The report highlights that the system is rewarding specialty care over prevention, but individuals can prioritize prevention to stay healthier longer.

• Understand your plan: Rising premiums and deductibles mean higher out-of-pocket exposure. Review your coverage each year and consider whether a high-deductible plan paired with an HSA makes sense.

• Ask about alternatives: New therapies, like GLP-1 medications for weight loss, may offer different risk/benefit tradeoffs than surgeries or procedures. Patients should ask providers to explain all available treatment paths.

• Be wary of surprise billing: Price variation is extreme. Always confirm in-network status for both facilities and individual providers before care.

Consumer Guide

How to navigate an expensive, inefficient system:

1. Check quality ratings: CMSs Care Compare, Leapfrog, and state report cards can provide useful hospital and provider benchmarks.

2. Dont skip primary care: A strong relationship with a primary care doctor reduces the risk of late-stage chronic disease.

3. Monitor prescriptions: More than 75% of FDA-approved drugs are not deemed cost-effective abroad. Ask about generics and evidence-based alternatives.

4. Leverage employer benefits: Employers often offer wellness programs, telehealth options, or incentives for preventive care. Use them.

5. Know when to escalate: Emergency room upcoding has surgedmeaning patients are billed at higher levels of care. If the situation isnt life-threatening, consider urgent care or telehealth first.

The tower at Hollywood Burbank Airport went unstaffed for hours

By Mark Huffman of ConsumerAffairs

• Air traffic control staffing is stretched thin, leading to cascading delays, and in rare cases towers may be temporarily unstaffed.

• TSA and other essential airport personnel are working without pay, putting pressure on security lines and operational resilience.

• Airlines and industry groups warn that a prolonged shutdown could force reduced flight schedules, more cancellations, and deferred safety or oversight tasks.

Its always smart for airline passengers to keep close tabs on the status of their flights, but as the federal government shutdown enters a second week, its now even more important. The nations air travel system is beginning to show early signs of strain.

While flights are still operating, mounting pressure on the systems workforce and infrastructure is triggering more delays, sporadic operational gaps, and growing uncertainty for passengers.

Air traffic controllers remain on duty as essential personnel, but their ranks are under mounting pressure. Some regions are seeing staffing cuts of up to 50%, and increased sick calls have been reported.

In one high-profile incident, the air traffic control tower at Hollywood Burbank Airport went unstaffed for about six hours flights continued under remote guidance, but delays averaged 2.5 to 4 hours.

In Denver, arriving flights on Monday had an average delay of 39 minutes, with some exceeding 90 minutes, directly tied to depressed staffing levels.

Security lines and checkpoint delays

TSA officers are also working without pay, a burden that can degrade morale and increase personnel absences. Travelers are being cautioned to expect longer lines at security checkpoints, especially at busier airports.

If the shutdown continues, broader consequences may appear. The Federal Aviation Administration has paused or deferred nonessential work, including hiring, training, safety initiatives, and equipment maintenance. Aviation groups warn these backlogs will persist even after the shutdown ends.

Airlines have also signaled that to maintain safety margins, reductions in flight schedules or temporary ground stops may be needed.

What passengers can, and should do

1. Build in extra buffer time

Dont leave it to the last minute. Plan to arrive earlier than usual: two hours before domestic flights, and three hours or more for international departures, especially at large or busy airports.

2. Monitor flights proactively

Stay in close contact with your airline. Use airline apps and alerts expect notifications about delays, cancellations, or changes in gate or schedule.

3. Be ready to rebook or adjust plans

Even if your flight hasnt been canceled yet, disruptions may cascade. Know your rebooking options, and consider booking itineraries with greater slack (e.g. longer layovers).

4. Pack patience and essentials

Bring snacks, water, phone chargers, and any medication, in case youre delayed at an airport for hours. Having a backup plan for lodging wouldnt hurt.

5. Explore alternative travel modes

If your trip is flexible or regional, rail or bus travel might be less exposed to federal staffing constraints. For example, Amtrak is not operated by furloughed federal employees.

6. Use travel insurance or credit-card protections wisely

If your ticket or credit card offers trip disruption or cancellation protection, review the fine print now. Some plans exclude government-shutdowntype events, so confirm whether your coverage applies.

Bigger picture: how far could this go?

Travel experts warn that the system is in a fragile balance. The longer the shutdown goes on, the greater the risk of more serious operational fallout.

Staffing fatigue, increasing absenteeism, and mounting maintenance backlogs may force more aggressive scaling back of flight operations or temporary airport restrictions.

For now, federal officials and aviation unions are insisting that safety has not been compromised. But with tens of thousands of workers across aviation agencies either furloughed or working without pay, many industry watchers say the disruptions we are now seeing are just a preview of what might come if funding isnt restored soon.

All cuts of beef are up double-digits over the last 12 months

By Mark Huffman of ConsumerAffairs

• U.S. consumers are facing record-high beef prices, with ground beef and steak costs hitting historic levels.

• A shrinking cattle herd, drought, high feed and input costs, and trade disruptions are driving the surge.

• Shoppers can seek relief by choosing less expensive cuts, substituting other proteins, or exploring plant-based alternatives.

This past summers cookouts were a lot more expensive. Nationwide, beef prices have climbed to levels rarely seen before, with some retailers reporting $6-plus per pound for ground beef and $11 or more per pound for premium steak cuts.

According to USDA and market data, the average retail price for fresh beef has soared in 2025, outpacing inflation in many regions. The squeeze is being felt by families, restaurants, and smaller meat purveyors, alike.

The August Consumer Price Index for August showed a sharp increase in beef prices over the past 12 months. Ground beef prices were up 12.8% year-over-year in August, while choice cuts were up even more. Meanwhile, overall food costs were up just 3.2% during the same period.

Its more than just inflation

The forces behind the beef price surge are numerous and interlocking. The U.S. cattle inventory is at its lowest level in decades. Severe droughts in key grazing states have reduced forage, prompting ranchers to liquidate herds rather than risk further losses.

Recovering herd numbers takes years because cattle need time to reach maturity; the pace of rebuilding is slow.

Ranchers and feedlot operators are also facing steep increases in the cost of feed, fuel, transportation, labor, insurance, and regulatory compliance. These rising expenses tend to get passed downstream.

In some cases, ranchers are forced to sell breeding animals because holding them is no longer economically viable.

Trade barriers

Imports help buffer domestic supply, but theyve been constrained lately. For example, cattle imports from Mexico have been suspended due to concerns over the spread of parasitic pests like the New World screwworm.

Meanwhile, high tariffs on Brazilian beef trimmings, used in grinding operations, and trade uncertainties limit foreign supplies.

Despite rising prices, demand for beef remains robust. Many consumers arent willing to compromise, continuing to purchase beef at higher prices, increasing demand at the supermarket.

At the same time, there continue to be kinks in the supplyt chain. The meatpacking and processing sector is concentrated: a few large companies control much of the throughput.

Disruptions, labor shortages, and logistical constraints exacerbate the bottlenecks. Some analysts caution that elevated margins by intermediaries may play a role in further accentuating retail increases.

What shoppers can do

While consumers cant control macroeconomic forces, there are strategies for getting protein without busting the budget. Below are practical tips and alternatives:

1. Choose less expensive cuts

• Go for chuck, round, skirt, flank, brisket, or stew meat instead of premium steaks.

• Use those tougher cuts for slow cooking (braising, stewing, chili) to maximize flavor and tenderness.

• Ground beef with mixed grades or higher fat content often is cheaperuse it for burgers, meatloaf, tacos, etc.

• Buy value packs or bulk quantities and freeze what you wont use immediately.

2. Mix and stretch with other proteins

• Combine beef with pork, turkey, or chicken in ground meat blends (e.g., beef/turkey patties).

• Use lean ground chicken or turkey as a mainstay; they tend to be less volatile in price.

• Incorporate pork chops, pork tenderloin, or even seafood (cod, tilapia, shrimp) when affordable.

• Eggs, legumes (beans, lentils), tofu, and cottage cheese are protein-rich and lower-cost alternatives.

3. Try plant-based or hybrid products

• Meat alternative products (plant-based burgers, crumbles) are more competitive when priced lower. Their adoption is sensitive to price.

• Use blended plant-meat mixes like 50% beef + 50% textured vegetable protein to reduce cost and retain flavor.

• Canned beans, chickpeas, lentils, and soybeans make excellent protein additions to chili, tacos, stews, and casseroles.

4. Shop smart and regional

• Check local butcher shops, farmers markets, or direct-from-ranch sales. Fewer middlemen can mean smaller markups.

• Keep an eye on weekly deals, managers specials, or clearance (freeze immediately).

• Consider co-ops or freezer-sharing with family/friends to buy in bulk and split costs.

5. Watch portion sizes and waste

• Slightly reduce portion sizes (e.g. 45 oz per person instead of 8 oz).

• Use trimmings, bones, and off-cuts for broth or soups.

• Freeze leftovers promptly and reheat smartly to avoid spoilage.

Why more couples are turning to chatbots for advice and finding it actually works

• Nearly 40% of Gen Z couples say AI tools like ChatGPT have helped them communicate and feel closer, according to a new study from Marriage.com.

• Experts caution that while AI can be a useful self-reflection tool, it shouldnt replace real conversation or professional therapy.

• Counselors warn against overreliance on chatbots, noting that genuine connection and conflict resolution still depend on honest, in-person communication.

AI might not have a heart, but it turns out it can still lend one.

A new study from Marriage.com found that nearly two in five Gen Z couples say ChatGPT has helped them grow closer by improving how they communicate, resolve conflicts, and express emotions.

As artificial intelligence becomes part of daily life, many couples are discovering that tech tools designed to answer work emails or write essays can also offer surprising insights into love and connection. To learn more about this unexpected trend, ConsumerAffairs spoke with Marriage.com counselor Kirsty Macgregor about how AI is quietly reshaping modern relationships.

Turning to chatbots during relationship struggles

With 33% of survey respondents saying that AI understands their relationship struggles better than their spouse, how trusted is a chatbot when youre struggling with your partner?

AI can be a helpful self-reflection tool, but it should never replace professional relationship support, Macgregor said. AI chatbots lack clinical oversight and may miss critical signs indicating that someone needs genuine mental health support or therapy.

People seeking relationship advice from AI need to be mindful of its limitations. While many assume that AI offers unbiased advice, this is not always true. AI often tells us what we want to hear, offering understanding and reassurance without addressing underlying issues.

Becoming dependent on chatbots

Macgregor also cautions against developing an unhealthy dependence on AI chatbots.

In people with attachment challenges, or who are conflict-avoidant, overreliance on AI for emotional support can exacerbate existing problems, she said. Speaking to AI instead of addressing conflict with your partner means missed opportunities to strengthen the relationship through effective communication.

Avoiding conflict and judgment

The survey found that 41% feel more understood about their relationship issues when consulting AI, and 38% feel more confident handling them afterward. On top of that, 44% of married Americans have used AI for relationship advice.

So, what makes a chatbot so attractive for relationship advice?

Practically speaking, AI offers convenience and accessibility to young people who are familiar with digital tools, Macgregor explained. With AI, you can get advice on your relationship within seconds at zero cost. This is appealing in the modern era where we expect instant solutions.

Besides the practical elements, couples are turning to AI because it feels safer than confronting their partner directly or asking loved ones for advice. Most chatbots are designed to be supportive and nonjudgmental, so its easier for people to be honest about how theyre feeling without fear of criticism or other perceived consequences.

Risks to consider when consulting AI

While many consumers may think that AI is an unbiased, easy-to-use resource, Macgregor wants to emphasize to do so sparingly and with caution.

Heres some of her best advice:

• Treat AI as a self-reflection tool, not a substitute for real communication or therapy.

• You can briefly explain the situation youre facing and ask the chatbot to help you explore your feelings, clarify your thoughts, or consider different perspectives.

• You should prompt it to be as objective as possible, asking it to challenge your assumptions rather than simply agree with you. This helps prevent the AI from offering overly reassuring or biased feedback.

• Avoid making any serious decisions about your relationship based solely on AI advice. Chatbots lack the emotional nuance, lived experience, and clinical understanding needed to assess complex situations.

• We need to remember that everything we share online leaves a digital footprint, even in private chats. Its best to avoid including identifiable details such as full names, addresses, workplace information, or anything you wouldnt want shared publicly.

Remember that while AI can support awareness and reflection, meaningful change in relationships always requires real human dialogue and emotional presence, Macgregor said. If you ever feel stuck, its completely okay (and often very beneficial) to seek extra help from a qualified therapist or counselor.