The United States spent $5.7 trillion on healthcare in 2025, a 7.3% increase from 2024 and the third consecutive year in which growth exceeded 7%, according to CMS projections reported by KFF Health News. That amount accounts for 18% of the nation’s gross domestic product, nearly twice the average among peer countries, according to the Commonwealth Fund’s 2026 international comparison.
The same Commonwealth Fund analysis found that the US has the lowest number of primary care physicians per capita among comparable countries, with just 0.3 per 1,000 people compared with an OECD average of 1.1. Around 27 million Americans, approximately 8% of the population, remain uninsured. Among those with coverage that includes high out-of-pocket expenses or deductibles, people are much more likely to avoid necessary care because of cost than people in peer countries. The disparity between healthcare spending and outcomes remains a defining issue in the American system.
The problem is not a shortage of institutions, but how those institutions connect with one another. Records, specialists, insurers, laboratories, pharmacies, and complementary practitioners frequently operate through separate systems. The patient may have the only complete picture of their healthcare journey while also being the person with the least infrastructure to coordinate it. A nurse with a PhD in health policy described the issue simply: she could not navigate her own care.
The data indicates that patients have already begun looking for answers themselves. According to the National Center for Complementary and Integrative Health, 36.7% of US adults used complementary health approaches in 2022, compared with 19.2% in 2002. A 2026 study published in The American Journal of Medicine found that 58.8% of older adults had used at least one complementary approach within the previous year, while 76.4% had used one during their lifetime.
This structure creates a series of predictable problems. A patient may enter the healthcare system with one concern, only to see that concern pushed aside when a more urgent issue emerges. Another person may visit the same OBGYN for fifteen years and then receive a text containing a phone number when her insurance contract changes, without any transition or guidance. Her medical records remain in portals designed largely around billing rather than understanding. Scheduling can leave patients acting as the project managers of their own healthcare. These are not unusual exceptions. They are consequences of a system designed around the institutions delivering care rather than the individuals receiving it.
What would it take to change that structure? Not another portal or simply another app. The change needs to occur at the level of the organizing principle: the individual becomes the center, and everything built around that center follows. That is the shift Carrie Allen, founder and chief executive officer of the Holistic Health Hub, has spent her career preparing for. She focuses on personalization, the practice of making systems feel more human, and brings that perspective to healthcare with a clear argument: the fragmentation experienced by patients is not simply a failure of effort, but a failure of architecture.
Once the individual is placed at the center, the data model changes. Health information can be organized around a person’s healthcare journey rather than an institution’s billing cycle. Wearables, at-home tests, sleep records, and notes a patient maintains for herself can all become part of a shared context.
For Allen, one challenge was keeping track of information stored across different platforms. “I often struggled to remember where I had saved something, whether it was an Instagram post, a message I had sent to myself, or a screenshot,” she explains. In her view, healthcare currently has little space for this kind of personal context, despite the fact that it may be some of the most valuable information a practitioner could see. An individual-centered system gives people a place to create their own health record and decide what information to share and with whom.
The practitioner’s experience changes as well. Allen distinguishes between transactional health and relational health. In a transactional system, a ten-minute appointment can seem insufficient. In a relational system, where a practitioner has access to the patient’s wider context and the relationship continues over time, ten minutes can be enough. “Ten-minute appointments don’t have to be a bad thing when they sit inside a relationship,” she observes. The aim is not to remove short appointments, but to place them within a relationship that makes them useful. It represents a transition from transactional health toward relational health.
The cultural change is also visible in the people helping to drive it. “Women understand the problem immediately, because they have been the ones holding the system together for their families,” Allen says. They often manage aging parents and children at the same time, placing them in the sandwich generation and leaving many dissatisfied with how the system has functioned. Allen identifies the pattern directly. She says, “Wellness is our human attempt to DIY. The system was not built for them, and the people building its replacement have felt that most acutely. I am clear that this is for everyone. But it is no accident that the momentum is coming from the people the old system left out.”
The objections are familiar. Insurance companies may push back against greater cost transparency. Institutions may argue that the problem is too complex or extensive to solve. Others may question whether approaches outside conventional medicine should have a place in the conversation. Yet patients have already expressed their preferences through their choices, and institutions that overlook those choices may increasingly need to explain why the systems they built no longer meet the needs of the people they were designed to serve.
The next transformation in American healthcare may not require replacing every existing institution. It may instead come from changing what sits at the center of the system. The question is not whether healthcare can be reorganized around the individual, but whether the institutions that benefit from the current structure will allow that change to take place.
