American Exceptionalism: Our Healthcare Spending

PUBLISHED September 24, 2025

Healthcare costs keep rising. Since 1960, total expenditures have risen 178,040 percent before inflation. A Congressional Budget Office report said that up until 2008, the main cost driver was technological advancements that helped diagnose, treat, and prevent health problems.

Back in the 1950s and 60s, if a person had a heart attack, doctors would just prescribe bed rest and morphine, both inexpensive treatments. Major advances in coronary angiographies (medical imagery) since that time have allowed physicians to assess patient blockages and better diagnose heart disease, but these advances have in turn boosted our national health expenditures. 

Fast forward to today and medical science’s biggest innovation is weight loss drugs. While prescription drugs such as Ozempic and Zepbound can make people healthier, they cost an uninsured individual between $1,060 to $1,350 for a 28-day supply.

Even when prices for new technology go down, healthcare costs could still go up. Switching from an injection to a pill, for example, could reduce manufacturing costs and save on out-of-pocket expenses for weight loss drugs. The lower costs and the added convenience of being able to take a pill, however, would almost certainly boost demand and, in turn, monies paid to pharmaceutical companies. Our national healthcare expenditures would again rise.

After COVID-19, the biggest cost driver to national healthcare spending has become new enrollments. The Centers for Medicare and Medicaid Services projected that by the end of 2023, 93.1 percent of all Americans will have health insurance coverage. That growth reflects in part, more people being able to enroll in Medicaid and in part, tax subsidies for Obamacare plans.

Still, about 22m individuals would remain uninsured in our country.¹ And that is before accounting for people losing their healthcare under the Big Beautiful Bill. But theoretically, if our country wanted a universal healthcare plan, it would costs the nation approximately another $332 billion a year to put the people who are uninsured right now on the healthcare rolls.²

Any kind of transition to a universal healthcare plan will not be cheap. But remain optimistic—other western countries have been able to do it; the United States can too if it puts its mind to it.

Back of the Envelope Calculations

¹U.S. population (~330 million) x 6.9% uninsured (100%-93.1% insured) =~22.8 million people without health coverage.  

² Per capital health care costs in 2023 ($14,570, Table I) x 22.8m = ~$332 billion to insure the uninsured.