Rising claims and insurance premiums are squeezing employers and employees alike. The bigger question is whether continuing to spend more on the same healthcare model will ever reverse the chronic disease driving those costs.

Employers are feeling the crunch

Every year, businesses sit down with their insurance brokers and brace themselves for the next round of healthcare increases. Claims are up. Prescription costs are up. Premiums rise. Employers absorb what they can, but eventually some of those costs make their way to employees through higher premiums, deductibles, and out-of-pocket expenses.

Yet there is one glaring problem: we are paying more for healthcare, but Americans are still remarkably unhealthy.

The average annual premium for employer-sponsored family health coverage has climbed relentlessly, reaching $25,572 in 2024 — a 24% increase over five years, outpacing or matching both wage growth and inflation (Claxton et al., *Health Affairs*, 2024). On average, covered workers contributed roughly $6,296 per year toward family coverage that same year, and the typical deductible for single coverage was 47% higher than a decade earlier (Claxton et al., *Health Affairs*, 2024). Over a longer horizon, both family premiums and workers’ own contributions have grown at roughly three times the rate of wages (Kanimian and Ho, *JAMA Network Open*, 2025).

That is real money coming out of employers’ budgets and employees’ paychecks. And what are we getting in return?

The numbers should make every employer pay attention

Roughly 6 in 10 U.S. adults have at least one chronic condition, and 4 in 10 have two or more (Miller, *Public Health Reports*, 2026). Chronic conditions are responsible for 8 of the 10 leading causes of death in the United States (Miller, *Public Health Reports*, 2026).

This isn’t only an aging-population problem. In 2019, more than half (53.8%) of adults aged 18–34 already reported having at least one chronic condition, and nearly one quarter (22.3%) reported having more than one — with obesity (25.5%), depression (21.3%), and high blood pressure (10.7%) leading the list (Watson et al., *MMWR*, 2022). Among adults aged 20–44, the prevalence of diabetes and obesity rose significantly over the last decade (Aggarwal et al., *JAMA*, 2023).

These aren’t just health statistics. These are workforce statistics. These are the people employers are insuring.

Employers cannot control every healthcare expense. But when chronic illness accounts for such an enormous share of spending, continuing to focus almost exclusively on paying claims after disease develops doesn’t make financial sense. We have to start addressing what is driving the claims.

More healthcare doesn’t automatically mean better health

Modern medicine saves lives every day. There are medications, tests, procedures, and specialists that are absolutely necessary. This isn’t an argument against medicine. It’s an argument for better medicine.

Too often, healthcare becomes a cycle of managing one symptom after another. Blood pressure rises — add a medication. Cholesterol rises — add another. An employee develops reflux — another prescription. The medication causes a side effect — sometimes another medication is added. Pain develops — order imaging. Symptoms continue — refer to another specialist. Another diagnosis. Another prescription. Another test. Another claim.

Sometimes all of those interventions are medically appropriate. But existing fee-for-service models tend to prioritize symptom management, medications, and procedures over treating the root causes of disease through changes in health behavior (Livingston et al., *IJERPH*, 2021). If we never address modifiable contributors to a person’s declining health, we can become very good at managing illness without ever meaningfully improving health. And employers keep receiving the bill.

Prescription use gives us another glimpse at the scale

Medication isn’t inherently bad. It can be necessary, appropriate, and lifesaving. But our goal should not simply be to keep adding medications throughout a person’s lifetime.

When appropriate, healthcare should also ask: Why did this condition develop? What can be changed? Could nutrition, obesity, insulin resistance, sleep, inactivity, stress, smoking, alcohol use, nutritional deficiencies, or another medical problem be contributing? Can we improve the underlying condition enough that medication requirements decrease under medical supervision?

Sometimes the answer is no. But we should at least be asking the question.

Now look at our children

The next generation should concern employers just as much as today’s workforce.

To be clear, the data do not show that prescription use among children is at an all-time high. Roughly one in five children and adolescents — about 19.8% — used at least one prescription medication in the previous 30 days, and overall use has actually held steady or declined slightly since the early 2000s (Qato et al., *Pediatrics*, 2018; Hales et al., *JAMA*, 2018). That is hardly reason to look away.

The more defensible — and still concerning — story is what those children carry. Chronic physical, developmental, and behavioral health needs are emerging earlier, with asthma medications, stimulants, and antidepressants now among the most commonly prescribed classes in childhood (Qato et al., *Pediatrics*, 2018). Children are entering adulthood carrying health problems that previous generations often associated with later life.

Those children are our future workforce. If we don’t become serious about nutrition, physical activity, metabolic health, sleep, mental health, and prevention now, what will the healthcare bill look like when today’s children are 30, 40, and 50? We cannot afford to wait and find out.

Autoimmunity is the fastest-growing, and costliest, layer

Autoimmune and inflammatory illnesses show the same pattern in sharper relief: rising prevalence colliding with rising cost. As many as 50 million Americans are now living with one of the more than 140 recognized autoimmune diseases, and the incidence and prevalence of these conditions are climbing faster than genetics alone can explain (Shanmugam et al., *Arthritis & Rheumatology*, 2026). National survey data tell the same story at the biomarker level: the prevalence of antinuclear antibodies rose from 11.0% in 1988–1991 to 15.9% in 2011–2012 — roughly 22 million to 41 million people — with the steepest increase in adolescents, in whom prevalence more than doubled (Dinse et al., *Arthritis & Rheumatology*, 2020; Meier et al., *Frontiers in Immunology*, 2022).

The price tag is enormous. Direct health care costs for autoimmune diseases in the US now exceed $100 billion annually, before counting lost productivity and caregiver burden (Shanmugam et al., *Arthritis & Rheumatology*, 2026). Much of that spending flows to years of specialist management, laboratory monitoring, imaging, and expensive biologic and specialty medications — and for many patients those therapies are genuinely necessary and life-changing. But the same environmental and lifestyle shifts driving the increase — changes in diet, obesity, inactivity, sleep, and chronic stress — are also modifiable (Miller, *Arthritis Care & Research*, 2025). Treatment and prevention should not be competing philosophies. We need both.

Why “just take the medication” has become the default

There is a reason the reflex is always another prescription — and it isn’t only clinical. Two forces quietly push both patients and clinicians toward the pill.

The first is cost baked into the drug itself. Promotional spending concentrates on the newest and most expensive products, not the oldest and cheapest, which steers prescribing toward higher-priced options regardless of whether they change outcomes (Fulone et al., *Cochrane Database of Systematic Reviews*, 2023).

The second is advertising aimed straight at the patient. The US is one of only two countries that permits direct-to-consumer prescription drug advertising, and manufacturers spent more than $8 billion on it in 2023 (Kravitz, *Annual Review of Public Health*, 2026). Most of these ads lean on emotional appeals and rarely quantify a drug’s actual benefits or harms, yet the evidence is consistent: they increase consumer awareness, drive patient requests, promote clinician prescribing, and raise pharmaceutical spending (Kravitz, *Annual Review of Public Health*, 2026; DiStefano et al., *JAMA*, 2023). The enhanced patient–physician conversation they generate does not reliably translate into more appropriate medication use or better health (Fulone et al., *Cochrane Database of Systematic Reviews*, 2023).

The cumulative message — repeated across screens, feeds, and exam rooms — is that a medication is the answer. Often it is part of the answer. But when a multibillion-dollar marketing engine trains a whole population to ask for a drug by name, employers end up financing not just the illness, but the advertising that shaped how it gets treated.

We have forgotten how much lifestyle matters

Somewhere along the way, healthcare became increasingly focused on what happens inside the medical office. But health is largely lived outside of it. What we eat matters. How we sleep matters. Movement matters. Weight and metabolic health matter. Stress matters. Smoking and alcohol matter.

Compared with individuals who have no behavioral risk factors, those with two or more — smoking, obesity, excess alcohol, and physical inactivity — can expect to live, on average, 12 fewer years (Heath et al., *BMC Medicine*, 2024). Yet many Americans have lost the basic knowledge of how to fuel their bodies. Highly processed foods are everywhere. Added sugars are everywhere. Convenience has replaced cooking for many families.

Then healthcare often enters the picture after the consequences have already developed. We need to intervene earlier.

What if the goal were to need less healthcare?

Imagine a different approach to employer healthcare. Instead of simply creating another referral network, what if we actively worked to make employees healthier?

Instead of waiting for diabetes, identify insulin resistance and metabolic dysfunction earlier. Instead of simply prescribing for elevated blood pressure, also address weight, nutrition, sleep, stress, and other contributing factors. Instead of automatically treating every symptom in isolation, look at the whole person. Instead of assuming every new complaint requires another medication, test, or referral, determine whether something correctable is contributing. And when medication is needed, use it.

This isn’t anti-medication. It’s anti-unnecessary medication. There is a tremendous difference.

The evidence increasingly supports this direction. Opportunistic screening and brief intervention to support behavior change is effective and cost-saving for smoking cessation, and effective and cost-effective for hazardous drinking, obesity, and physical inactivity (Heath et al., *BMC Medicine*, 2024). Structured lifestyle interventions delivered in primary care have been projected to reduce both societal and healthcare costs while improving quality-adjusted survival (Saha et al., *PLoS One*, 2013). Lifestyle medicine — built on nutrition, physical activity, restorative sleep, avoidance of risky substances, social connection, and stress management — is an evidence-based approach to preventing, treating, and in some cases reversing chronic disease (Miller, *Public Health Reports*, 2026).

Employers need more than another wellness program

Employers don’t need another program that sends employees a brochure about eating vegetables and checks a box marked “wellness.” They need healthcare partners willing to engage employees before preventable problems become catastrophic claims.

The question shouldn’t simply be, “How can we negotiate a better insurance premium?” The better question is, “What are we doing to improve the health of the people generating the claims?”

Because the cycle is becoming unsustainable. More illness creates more claims. More claims create higher employer costs. Higher employer costs contribute to higher premiums and greater cost-sharing. Employees take home less money. And despite spending more, we still haven’t solved the underlying health problem. Employers and employees are both paying the price.

It’s time to change the conversation. Healthcare should absolutely treat disease. But it should also work aggressively to prevent disease, improve chronic conditions, address modifiable contributors, and — when safely possible — reduce the need for additional interventions.

Any medication reduction or discontinuation should always be individualized and medically supervised; some patients will appropriately require long-term treatment. But we should refuse to accept the idea that continually adding treatment without investigating modifiable contributors is the only option.

Because lowering healthcare costs shouldn’t begin with providing less care. It should begin with helping people need less of it.

This is the work of Mindset & Body Reset

At Mindset & Body Reset, “less is more” is not a slogan — it is the goal. Success is not measured by how many prescriptions are written or how many referrals are generated. When medically appropriate, the opposite is the aim: helping people improve their health enough that, over time and under medical supervision, they may need fewer medications, fewer tests, and less healthcare overall.

That means treating the whole person — mental health, metabolic health, nutrition, sleep, movement, stress, and the modifiable factors driving chronic symptoms — and using medication decisively when it is truly needed. Use medication when it’s needed. Look deeper when something can be corrected. Help the body become healthier whenever possible.

For employers, this is the partner the current model is missing: not another wellness brochure or a renegotiated premium, but a team working to shrink the disease that generates the claims in the first place — for today’s workforce and for the children who will become tomorrow’s.

The invitation is simple. Stop asking only how to pay for illness, and start asking how to prevent it. Bring Mindset & Body Reset in before preventable problems become catastrophic claims. Because the healthiest workforce — and the most sustainable healthcare budget — is built on helping people need less, not on giving them less.

Let’s change the conversation. Let’s help people get healthier. Let’s make less, more.

At the heart of Mindset & Body Reset is Lori Leonard, whose work is centered on changing the way people think about their health and healthcare. Through Mindset & Body Reset, Leonard focuses on helping individuals and employers look beyond simply treating symptoms and instead address the lifestyle and underlying factors that can contribute to chronic health problems. Her approach emphasizes the whole person — including nutrition, metabolic health, movement, sleep, stress and mental well-being — while recognizing that medication remains an important tool when it is medically necessary. For Leonard, the ultimate goal is simple: help people become healthier, improve their quality of life and, when safely possible, help them need less healthcare over time.