For many Americans the question may not be "how bad is it?" but rather, "can I afford to get this looked at?"
I've been thinking a lot about what it really costs to stay alive in this country. Not in the spiritual sense - in the literal one. The bills. The trade-offs. The quiet math families do when pain meets the price tag.
When I was 20, I broke my ankle. I had insurance. I did everything I was supposed to. Still, I'm paying for it - literally - years later. The surgery cost nearly $50,000. Even with insurance, I owed more than $10,000 out of pocket - payments that stretched on long after my leg healed.
More recently, I hurt my wrist chopping firewood to heat our home. My first thought wasn't "how bad is it?" it was "can I afford to get this looked at?"
That's the part people outside this reality don't understand. It's not the injury that breaks you, it's the hesitation. The pause before asking for help because you already know the answer: it depends on your deductible.
Across the Shenandoah Valley where I live, people make this same calculation. Can I afford to get better?
We don't talk about it much, but the numbers tell the story plain: about four in 10 adults in America carry medical or dental debt, and rural folks are more likely to struggle with it than people living in urban areas. Research shows medical problems and bills are among the leading contributors to personal bankruptcy. And for about seven in 10 adults with health care debt, the bills came from a one-time or short-term medical expense - a single hospital visit, an ER trip, or an unexpected procedure. One broken bone. One bad diagnosis. One stroke of bad luck, and your whole future can tip.
You learn to live smaller after that, to stretch prescriptions, to work through pain, to keep quiet about what hurts. To walk around with the silent fear that your body might betray your budget.
We've all become experts at pretending the system is normal, because it's the only one we've ever known. But it's not normal, it's a choice.
Other nations - Norway, Canada, Germany, France, Japan, just to name a few - have made different choices about how to care for their people. None of them are perfect, and they're not all the same. But they've each decided on one simple idea: getting sick shouldn't mean going broke.
These countries pay for it in different ways, some through higher taxes, some through shared insurance systems, but the result is the same: people don't have to hesitate before calling a doctor when something's wrong. It's not socialism. It's just a society deciding that health care is part of the common good - like roads, schools, or clean water.
When I spoke recently with journalists from Norway and Sweden, they told me what care looks like where they live.
In Norway, a hospital stay doesn't come with a payment plan. Education is free, prescriptions are affordable, and families don't go bankrupt because a child gets sick.
People still work hard - farmers, factory workers, teachers - but they do it knowing one injury or illness won't destroy everything they've built.
They pay more in taxes, but what they get in return is peace of mind. They don't hesitate before calling the doctor. They don't lie awake wondering if this month's paycheck will cover both medicine and the electric bill.
It's not a perfect system, none are, but it's one built on the idea that care is a shared responsibility, not a luxury.
Here in America, we've built something powerful - some of the best hospitals and doctors in the world. But access to them depends on what's in your wallet.
Unfortunately, we also end up paying more for worse results by almost every measure: lower life expectancy, higher infant mortality, and higher rates of chronic illness than other wealthy nations. In the country with the largest economy in the world, we still treat health care like a privilege to be earned. We've built a system where survival comes with fine print, where you can buy a truck on credit more easily than you can see a specialist.
I don't bring this up as a political argument. This isn't about right or left, it's about right or wrong.
It's about neighbors, parents, co-workers - about the next time you hear someone cough in a quiet room and realize how fragile we all are - how easily health can become debt.
When I think about the future I think about my children and how I want them to inherit something better than this quiet cruelty. I want them to live in a country where care isn't a privilege you earn but a promise we keep to one another.
Because someday, it won't just be a headline. It'll be someone you love sitting in an exam room, staring at a clipboard, doing the math in their head.
Wondering if healing is something they can afford.
We can do better than that.
We have to.
Because in the land of plenty, no one should have to go broke just to stay alive.
Andrew Tait is a father, farmer, and factory worker living in Shenandoah County, Virginia.
This article first appeared on The Daily Yonder and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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Previously Published on dailyyonder.com with Creative Commons License
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