The 21 Hats Morning Report

The 21 Hats Morning Report

Is the Rising Cost of Health Care Killing the American Dream?

If the U.S. health system were a country, in dollar terms, it would be the third-largest economy in the world.

Loren Feldman's avatar
Loren Feldman
Dec 11, 2025
∙ Paid

Here are today’s highlights:

  • Shocked by the cost of beef in grocery stores? Just imagine if you owned a steak house.

  • Google has started penalizing businesses that hide their pricing.

  • Recent trends have not been kind to house-flippers.

  • Retailers are relying increasingly on AI to forecast sales trends and foot traffic, but there’s a big use case that the technology has yet to master.

HEALTH CARE

Employers pay most of workers’ health-insurance premiums, but those costs are passed on to workers in the form of lower wages and fewer jobs: “Despite devastating out-of-pocket costs, Americans are generally insulated from the true cost of health care premiums. However, the expiring subsidies on the Affordable Care Act marketplaces, where more than 20 million Americans get their insurance, show just how exorbitant premiums have become. Consider a 60-year-old couple earning $85,000 a year. Without subsidies, their health insurance premiums next year will approach $32,000.”

  • “Those of us who get health care insurance from our employers — some 160 million Americans — may be breathing a sigh of relief. But our health care premiums are also staggering (an average of $27,000 a year for a family of four), and the fact that our employers pay part of the tab isn’t much of a reprieve.”

  • “That’s because decades’ worth of research shows that, even though employers pay most of workers’ premiums, those costs are passed on to workers in the form of lower wages and fewer jobs. That’s why the rise in health spending above the rate of inflation over the past decade has depressed wages by nearly 10 percent, according to my calculations.”

  • “Next year insurance premiums will increase 10 percent for employer-sponsored plans and 18 percent for individual plans on the exchanges compared with 2025. In both markets, they’re going up because the price of medical care is rising (think hospital mergers, staffing shortages, and tariffs that make drugs and devices more expensive) and Americans are increasingly using expensive weight loss and diabetes drugs known as GLP-1s.” READ MORE

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