Illustration: Sarah Grillo/Axios

Health insurance through an employer — the way most Americans get it — costs an annual average of almost $23,000 to cover a family. That's enough to buy a new Volkswagen every year.

The big picture: While those costs keep rising, Americans' life expectancy is falling.

By the numbers: Altogether, the U.S. spent $3.6 trillion last year on health care.

  • We spend far more than any other wealthy country, and we are no healthier for it.

Be smart: We don't spend so much because we go to the doctor more than people in other countries. It's because we pay much higher prices for the same services — for MRIs or a knee replacement or new drugs — and those costs keep going up.

Our actual health isn't great, either.

  • Americans' life expectancy has been declining for three straight years — the first time that's happened in decades.
  • That's largely a product of the opioid crisis, which has proven difficult to arrest, in part, because the U.S. spends its money on treating physical illnesses, rather than on prevention or mental-health treatment.

These colliding crises are why health care is so dominant in the 2020 debate — and why it will stay that way.

Go deeper:

Go deeper

Dan Primack, author of Pro Rata
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Illustration: Aïda Amer/Axios

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