Research

The State of the U.S. Healthcare Experience

We surveyed Americans about their experience with healthcare costs, insurance, and navigating the system.

We asked real people about their experience with the U.S. healthcare system. Here's what they told us.

Key Findings

86%

have avoided or delayed care due to cost uncertainty

76%

have received a surprise medical bill

95%

would use a price transparency tool

90%

want help navigating the healthcare system

People are skipping care they need

86%have avoided or delayed healthcare because of cost uncertainty. People aren't making medical decisions based on health. They're making them based on fear of the bill.

86% Avoided or delayed care
14% Did not avoid care

Surprise bills are the norm

76% have received a surprise medical bill. Nearly a quarter said it happens frequently.

24% Frequently (3+ times)
52% Occasionally (1-2 times)
24% Never

Nobody can tell you what anything costs

We asked: “When estimating the cost of a healthcare service, which of the following were major pain points?” Respondents could select all that applied.

The results show frustration at every level.

Getting clear pricing from providers76%

of respondents selected this

Understanding what insurance would cover71%

of respondents selected this

Knowing where to go (urgent care, ER, PCP, etc.)52%

of respondents selected this

Distinguishing in-network vs. out-of-network14%

of respondents selected this

Billing is broken at every step

We tested four basic assumptions. Respondents disagreed with all of them.

I know the full cost before receiving a major medical service.

55% disagree

I find it easy to compare prices across providers.

55% disagree

The process of paying medical bills is straightforward.

55% disagree

I trust that the billed amount is accurate.

35% disagree

How people find care today

Nearly half just Google it. No one has a dedicated tool for navigating healthcare.

48% Google
24% Insurance portal
10% Zocdoc
5% Friends & family
13% Other

In their own words

I delayed a lab test because I wasn't sure if my insurance would cover it fully.

On avoiding care / Anonymous respondent

Received a bill months after a procedure that didn't match my expectations. Took weeks to resolve.

On surprise billing / Anonymous respondent

My insurance often denies covered procedures. Getting them to pay is a battle every time.

On insurance denials / Anonymous respondent

The demand is clear

95%

would use a price transparency tool

90%

want a healthcare navigation service

That's not a niche. That's everyone.

That's why we're building Elena

A personal healthcare assistant that fights for you. She finds the best prices, calls your doctor, manages your insurance, and makes sure you never get surprised by a bill again.

Try Elena

Methodology

This survey was conducted in March 2026 with dozens of respondents across the United States, ages 18-57. Respondents were sourced through direct outreach. The sample skews younger and is not nationally representative. These results are directional and reflect real pain points experienced by real healthcare consumers.

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