Simply having health insurance coverage is not always enough for Americans to afford their care. More than 30% of Americans who have insurance still face a financial barrier to care, including trouble paying medical bills or other out-of-pocket costs.

In addition to high out-of-pocket costs, health plans use utilization management tools, like requiring prior authorization or failing first on other therapies, which can create significant barriers. Patients with some of the most serious chronic diseases – autoimmune diseases, allergies and diabetes – are more likely to report experiences with these health plan barriers than other Americans who take prescription medicines.

While health care providers like doctors and nurses are there for patients at pivotal moments, hospital administrators often take advantage of the system to pad their bottom lines at the expense of patients. In fact, hospitals are the largest share of health care spending in the United States and are a driver of higher cost sharing and premiums for patients across the country.

To fix our health care system, we need a robust discussion about the barriers patients face to accessing their medicines and the drivers of health care spending.