Affordability Is a Clinical Issue Not Just a Financial One

Let’s stop talking about affordability in healthcare…because for too many Americans, it’s not affordable. And all of our rhetoric around affordability has done little to close the widening access gap that presents itself in everyday choices for Americans:  Do I fill my prescription for my diabetes medication? Do I schedule a follow up with my cardiologist or gastroenterologist? Do I vaccinate this winter? Do I get a screening colonoscopy or mammogram? Can I even afford my annual physical exam?

These decisions impact your health long before you present to my colleagues and I in the Emergency Department. And by the time they do, the consequences of delayed care are already apparent. Lack of access shapes how sick you are when you are diagnosed, your ability to manage your symptoms at home, your ability to recover, and ultimately, your ability to balance your family, friends, and work responsibilities. That’s why the conversation can’t simply be about making healthcare more “affordable.” We need to talk about whether people can actually access care when it can still change the trajectory of their health. 

That was the topic of a panel I spoke on last week at Health Connect South. Along with John Stitt from Merck and Amanda Free from Anthem, Blue Cross and Blue Shield of Georgia, we dove into affordability and the impact it has on preventative care in the South. 

I see it when a patient delays care because a doctor visit, an expensive prescription or an imaging test feels financially out of reach. By the time that patient arrives in the emergency department, a manageable problem may have become a medical crisis. That is why affordability belongs in the clinical conversation. The consequences of unaffordable care extend beyond a bill or a spreadsheet. They show up with the patient at the bedside. 

The Cost of Delayed Care 

Too often patients are making difficult calculations when it comes to their health. Can I afford the appointment? Can I miss a shift at work? Can I pay for the medication and still cover groceries? Access is shaped by all of these factors, and cost sits at the center of many of them. In Kaiser Family Foundation’s April 2026 update, 36% of US adults reported that they skipped or postponed needed healthcare in the past year due to cost.  

When patients wait, their options often narrow. A chronic condition that could have been managed in a primary care setting may worsen. An infection that might have responded to an early course of treatment may require hospitalization. A symptom that deserved timely evaluation may go unexplained until the disease is more advanced. The patient bears the greatest burden, but the effects extend across the healthcare system through higher-acuity visits, longer stays and greater demand on already stretched clinical teams. 

Emergency departments will always be there for people in moments of urgent need. But we should not accept a system in which the emergency department becomes the sole entry point because earlier care was too expensive or too difficult to reach. Improving affordability means helping patients get the right care sooner, in the right setting, before fewer and more costly choices remain. 

Where Artificial Intelligence Can Help 

Artificial intelligence is becoming part of this discussion because it may help healthcare organizations reduce administrative friction, support clinical decisions and make information easier to use.  

Documentation is necessary, but it can consume a significant share of a clinician’s day and pull attention away from the patient. Ambient scribing offers one of the clearest opportunities, and is being used already. The tool can listen to a clinical conversation and help draft the note for the clinician to review. Used well, ambient scribing may reduce documentation burden, improve the completeness of the record and return valuable time to the bedside. That does not automatically make care less expensive, but reducing unnecessary administrative work is part of building a more efficient and more human system. 

Real-time clinical decision support may create another opportunity. AI can analyze patterns and cross reference the latest research and clinical data to surface information that would previously have taken hours to find or was not readily available. Access to this information can strengthen clinicians work more efficiently, while also helping to prevent missed diagnoses, duplicative testing or avoidable complications. Ultimately, that can lead to increased affordability for patients. 

There are risks though. While technology can widen access, it can also deepen existing gaps. We need to ensure there are safeguards in place and technology is not becoming a means to remove empathy, physician oversight, and clinician decision making. There is a lot to be worked out in this space going forward, but if done right, it represents an exciting opportunity for clinicians and patients. 

Innovation to Deliver the Right Care at the Right Time 

The Health Connect South conversation reinforced what I see in the emergency department. Affordability is an ongoing issue that needs to be addressed. When people delay care because of cost, the consequences are measured in more than dollars. Treatable conditions become more serious, options become more limited and patients often enter the healthcare system at its most expensive point. 

Technology, including AI, can help us remove inefficiencies, give clinicians more time with patients and make health information easier to use. But innovation only matters if it helps more people receive the right care at the right time. That should be the standard by which we measure progress: not simply whether healthcare becomes more advanced, but whether it becomes more accessible and affordable for the people who depend on it.