Great start Halle, and a few things we've talked about before. I come from an end-user cost perspective since that is my passion and the problem I'm trying to solve with my company. Here are some major facts impacting the out-of-pocket costs for households and highlights why this is a major problem in the US:

• Total cost to American families for their healthcare has more than doubled to $19,393 from $9,235 since 2002. http://www.npr.org/blogs/health/2011/05/11/136213104/you-really-are-paying-a-lot-more-for-health-care?ps=sh_sthdl
• Deloitte just released a new estimate that consumers spend almost 20% of their household income on healthcare (much higher than previous estimates of 16%). http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/US_CHS_HiddenCostsofUSHealthCareforConsumers_032111.pdf
• Employers are increasing deductibles and replacing co-pays with coinsurance, requiring workers to spend more out-of-pocket at the point of care. Coinsurance will also be more common for prescription drugs starting in 2011. This year (2011), for the first time, most employers are expected to have a deductible of at least $400 (and often more), whereas in 2009 the most common plan had no deductible. An incredibly fast shift. http://www.pwc.com/us/en/health-industries/publications/behind-the-numbers-medical-cost-trends-2011.jhtml
• 63% of employers said they'll increase the proportion of insurance premiums paid by their employees for 2011. 46% plan to raise the limit on annual out-of-pocket payments; 44% plan to raise deductibles for in-network services. http://blogs.wsj.com/health/2010/08/19/big-employers-estimate-health-care-costs-will-rise-89-in-2011/
• 72 million, or 41%, of non-elderly adults have accumulated medical debt or had difficulty paying medical bills in the past year -- and 61 percent of them had insurance. http://www.healthreform.gov/reports/families/index.html
• 75% of individuals looking for coverage on the individual market never bought a plan, with 61% of those that did not purchase insurance citing premium costs as the primary reason. http://www.healthreform.gov/reports/families/index.html
• Families who purchase health insurance on the individual market face even higher out-of-pocket costs - nearly 60% more in deductibles and copayments than a family that gets insurance through work. http://www.healthreform.gov/reports/families/index.html
• 45% of non-elderly adults reported difficulties getting needed care because of cost (2007)...they forego regular check-ups and screenings, skip medicines, and avoid other preventive measures, whether insured or not. http://www.healthreform.gov/reports/families/index.html
• Fewer employers offer coverage...trend will continue. Between 2000 and 2009, the percentage of firms offering health insurance coverage to their employees declined from 69 to 60; for firms employing less than 10 workers, the decline was even greater - from 57 to 46 percent. http://www.healthreform.gov/reports/families/index.html
• A 40% tax on "high cost" health plans will be imposed in 2018. http://www.npr.org/blogs/health/2011/05/11/136213104/you-really-are-paying-a-lot-more-for-health-care?ps=sh_sthdl