Why Americans Say Healthcare Is in Crisis — and Why I Wrote Hospital Bill Survival Guide and Humanizing Revenue Cycle Management

Americans have spoken clearly, and the message is getting louder.

According to new Gallup research, 29% of Americans now say healthcare cost is the most urgent health problem facing the country, the highest level in more than two decades. Satisfaction with the cost of U.S. healthcare has dropped to a record low of 16%, and nearly 7 in 10 Americans say the healthcare system has major problems or is in a state of crisis.

This isn’t a messaging problem.
It’s a systems problem.

And it’s exactly why I wrote Hospital Bill Survival Guide and Humanizing Revenue Cycle Management.

The Cost Crisis Isn’t About Medicine. It’s About the Financial Experience.

When people say “healthcare costs too much,” they’re rarely talking about the science of medicine or the skill of clinicians. They’re talking about the moment the bill arrives.

They’re talking about:

• Being quoted one price and billed another

• Not knowing what insurance covered or didn’t

• Learning about charity care only after collections started

• Getting five bills from five entities for one encounter

• Feeling ashamed, confused, or powerless when trying to ask for help

Gallup’s data shows something important and often misunderstood. While only 16% of Americans are satisfied with healthcare costs nationally, 57% are satisfied with their own healthcare costs.

That contradiction tells us everything.

Most people are fine until they’re not.

Cost harm in healthcare is episodic, concentrated, and unpredictable. You don’t experience it every year. But when you do, it can destabilize a household overnight. That uncertainty is what people are responding to. Not personal dissatisfaction, but systemic fear.

This Is the Trust Gap I’ve Spent My Career Working On

I’ve spent more than two decades inside healthcare finance, analytics, and revenue cycle operations. I’ve sat in boardrooms, built models, launched technology, and watched well-intentioned systems accidentally harm the very patients they serve.

Over time, one truth became impossible to ignore.

Healthcare doesn’t feel human once money enters the conversation.

That’s why I wrote Humanizing Revenue Cycle Management. It was never about softening the business of healthcare. It was about fixing the blind spot. The one where complexity, automation, and policy quietly strip dignity from the patient experience and ultimately backfire financially.

And it’s why I later wrote Hospital Bill Survival Guide. Because patients shouldn’t need insider knowledge to survive a billing system they didn’t design.

Americans Aren’t Asking for Free Care. They’re Asking for Fairness.

Gallup also found that 64% of Americans now believe the federal government should ensure everyone has healthcare coverage, the highest level since 2007. That doesn’t mean Americans agree on ideology. They don’t.

What they agree on is this:

• The system feels stacked

• The rules feel opaque

• The risk feels one-sided

When people can’t understand costs, can’t anticipate bills, and can’t access help without digging through fine print, trust erodes. And when trust erodes, policy pressure follows.

I’ve warned healthcare leaders for years that revenue cycle failures eventually become political problems. Gallup’s data shows we’re already there.

Humanizing the Revenue Cycle Is Not Optional Anymore

Hospitals often separate “finance” from “experience.” Patients never do.

From the patient’s perspective, billing is the system.

If it’s confusing, adversarial, or humiliating, it colors everything else. Clinical excellence can’t compensate for financial chaos.

Humanizing the revenue cycle doesn’t mean ignoring margins. It means protecting them by:

• Giving patients clarity before care

• Applying financial assistance proactively

• Training staff to have empathetic, solution-oriented conversations

• Designing systems that assume confusion, not sophistication

• Treating dignity as an operational requirement, not a brand value

The Gallup data confirms what patients have been telling us quietly for years. Cost anxiety is shaping how Americans see healthcare as a whole.

Why I Wrote These Books

I didn’t write Hospital Bill Survival Guide to criticize hospitals. I wrote it so families wouldn’t feel alone or ashamed navigating a system that overwhelms even experts.

I didn’t write Humanizing Revenue Cycle Management to make finance leaders uncomfortable. I wrote it because the fastest path to sustainable margins runs straight through patient trust.

These books exist because:

• People want to pay, but need help

• Systems can be both compliant and compassionate

• Transparency is cheaper than collections

• Inaction is the costliest decision of all

Gallup didn’t just publish polling data. They published a warning. One that healthcare leaders and policymakers should take seriously.

The question isn’t whether the system feels broken.
Americans have already answered that.

The question is who’s willing to fix the part that hurts people the most.