too rich or too poor…
Low- to mid-income families sit in the most punishing position in the U.S. healthcare system because they absorb maximum risk with minimum protection.
They live in what can be described as the coverage gap of capitalism:
Too “rich” for public assistance
Too “poor” for private resilience and access
This group is expected to behave like financially sophisticated risk managers… while juggling jobs, kids, housing costs, and unpredictable health needs.
The reason “healthcare” feels unpleasant is because it violates three deeply held expectations people bring to the system:
If I do the right thing, I should be protected
Insurance should reduce risk, not introduce more of it
Care decisions should be clinical - not financial or bureaucratic
When those expectations collapse, the reaction feels like stress AND betrayal.
Healthcare costs generate:
Anger at systems that feel rigged
Shame for needing help or falling behind
Fear of getting sick or injured at the “wrong” time
Avoidance of care until crisis hits
Moral injury, especially for parents forced to choose between financial stability and their child’s health
This isn’t just an economic problem, it’s a trust problem.
Looking at JUST premiums - Between 1999 and 2024, family health insurance premiums rose about 342%, while average worker earnings rose about 119%.