Report warns healthcare could consume 20% of GDP by 2033
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U.S. health spending is growing faster than the economy and will reach 20.3% of GDP by 2033.
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Six structural problemsfrom price disparities to chronic diseaseare pushing the system toward crisis.
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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:
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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.
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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.
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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.
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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.
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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:
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Check quality ratings: CMSs Care Compare, Leapfrog, and state report cards can provide useful hospital and provider benchmarks.
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Dont skip primary care: A strong relationship with a primary care doctor reduces the risk of late-stage chronic disease.
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Monitor prescriptions: More than 75% of FDA-approved drugs are not deemed cost-effective abroad. Ask about generics and evidence-based alternatives.
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Leverage employer benefits: Employers often offer wellness programs, telehealth options, or incentives for preventive care. Use them.
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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.
Posted: 2025-10-07 13:36:46