Millions of Americans watch their paychecks shrink under premiums, deductibles, and medical bills that rise faster than their wages. Warren Buffett, the longtime Berkshire Hathaway CEO, drew a straight line between those bills and the country's economic standing.
At Berkshire's 2017 shareholder meeting, he told investors that healthcare costs had become a direct threat to American competitiveness.
Buffett compared what business leaders complained about to what was actually happening in the numbers. He said corporate taxes had fallen from 4 percent of GDP to 2%, while healthcare spending had climbed from 5% to 17%. That shift, he argued, mattered far more than any tax debate. It wasn't abstract. It was altering wages, investment decisions, and how far American companies could stretch every dollar. That was when he delivered the remark that has followed him ever since: "Medical costs are the tapeworm of American economic competitiveness." He also said the issue had become "the single biggest variable throwing us out of whack compared to the rest of the world," a warning directed at both executives and policymakers.
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Those comments created an unmistakable spotlight on the forces driving costs higher. They also set the stage for one of the most ambitious corporate partnerships in recent memory. In early 2018, Amazon, Berkshire Hathaway, and JPMorgan Chase announced an independent nonprofit created to tackle healthcare spending for their workers.
Together they employed more than a million people and carried more market power than most countries. The plan was to test whether a simpler, more transparent approach could deliver better care at a lower cost.
Amazon founder Jeff Bezos described the aim as difficult but worth pursuing. JPMorgan Chase CEO Jamie Dimon said the country needed a system that rewarded value rather than layers of fees. Buffett believed employers were feeling the burden more intensely each year and saw the project as a chance to reset how benefits were designed. The venture was later named Haven, and for a brief moment it reshaped expectations around what major employers could attempt.
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Haven ended in 2021, not because the problem disappeared but because the system resisted major change. The companies said they still learned from the effort and incorporated pieces into their own benefit programs.
The national picture, though, continued moving in the same direction Buffett had outlined. The U.S. already spent far more per person on healthcare than other wealthy nations, and the gap has only widened. Costs that consumed about 18% of GDP in 2018 are nearing 20% in 2025, with health spending projected to reach $8.6 trillion by 2033.
Family coverage has become one of the sharpest pressure points in employer insurance. According to the Kaiser Family Foundation's annual employer health benefits survey, the average family premium for employer-sponsored plans has reached $26,993 this year. Workers now contribute $6,850 of that total, while employers cover the rest, a split that forces many households to spend more each year just to hold on to the same coverage.
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Rising hospital labor costs, consolidation, drug pricing trends, and administrative load all push the numbers higher. Households feel it through deductibles and copays that stretch budgets thin, while employers feel it in benefit costs that outpace revenue growth.
Buffett's warning from 2017 lands differently today. He spoke to shareholders about a problem that was already reshaping the country's economic footing, and the years since have followed the trajectory he described. Healthcare costs still weigh on wages, business decisions, and household stability. The tapeworm image stuck because it matched the reality workers and employers were already living.
Seven years later, the country remains in the same bind. The bills are larger, the stakes are higher, and the gap with other nations is even wider. Buffett's message was straightforward in 2017, and the numbers now tell the rest of the story.
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