Twenty-seven million Americans are uninsured. And nearly one in four who are covered skip or delay care because of cost. As of January 1, more than 20 million ACA enrollees watched their premiums double when enhanced subsidies expired, and Medicare telehealth flexibilities are currently hanging by a thread. None of these crises happened in isolation. They converged, and millions of Americans are feeling the impact all at once.
The Cracks Aren’t New. They’re Just Wider.
In daily life, this impact looks like a woman rationing thyroid medication until her deductible is met. Or an adult son burning PTO to drive his father to appointments that could have been handled virtually. Or a family having to choose between scheduling their annual check-ups and putting food on the table. Scenarios like these aren’t outliers. They’re the new normal for a growing segment of the population.
Patients Aren’t Waiting for the System to Catch Up
From my perspective as the CEO of a digital health platform, I see it clearly: a growing number of consumers are bypassing the traditional system altogether. They’re paying cash for generics because it works out cheaper than a copay. They’re skipping the waiting room entirely and connecting with licensed physicians online, after hours, because that’s when they have time to attend to their health.
This isn’t a temporary blip. It’s a behavioral shift, supported by digital healthcare platforms that offer what traditional systems often can’t: access, speed, and transparent pricing. The question for healthcare leaders isn’t whether this is happening. It’s whether you’re evolving along with it.
A Foundation, Not a Fallback
There’s a tendency in this industry to view direct-to-patient platforms as a last resort for people who “fall through the cracks.” That framing underestimates the scale.
When 27 million Americans are uninsured and nearly a quarter of those with insurance can’t afford to use it, we’re not talking about a few cracks. We’re talking about a chasm, and a population large enough to warrant its own infrastructure. The elements of that foundation aren’t complicated. I saw them in action growing up.
My parents ran the only pharmacy in our small town in Ireland, where people walked in, got answers, and left with exactly what they needed. Healthcare wasn’t abstract. It was personal, local, and accessible. This is the standard that digital health should aspire to: direct access to licensed physicians, transparent pricing, and FDA-approved medications delivered without the friction of prior authorizations, network restrictions, or surprise bills.
To be clear, telehealth does not and should not replace full-spectrum care. Patients who need diagnostics, imaging, or complex treatment protocols will always require in-person services. But for the millions who need prescription access for chronic conditions, acute infections, and everyday medications, digital platforms are simply the better option.
The Caregiver Equation
Let’s not forget that the healthcare coverage crisis doesn’t just affect those seeking care. When a senior loses access to virtual care—whether through policy lapses, coverage gaps, or shifting regulations—the burden lands on their adult children: the “sandwich” generation already juggling jobs, kids, and their own healthcare needs. Every in-person appointment that could have been virtual represents a day off work, another task to manage, and compounding stress. Digital health leaders should be thinking about this multiplier effect. Are we building tools that support caregivers, or are we adding to their load?
A Choice Point for the Healthcare Industry
I’ve spent over two decades scaling businesses across global markets, and what I know for sure is that consumer behavior always outpaces institutional response. The companies that win are those that build for where customers are going, not where the industry wishes they’d stay. Healthcare is no exception.
Millions of Americans have already integrated digital platforms into how they manage their health. They’re not abandoning traditional care. They’re supplementing it with tools that meet them where they are. The question is whether the industry will recognize this shift and build alongside it.
My money is on the builders.
About Vanessa Slowey
Vanessa Slowey is CEO and President of TelyRx, a digital healthcare platform transforming patient access to physician care and FDA-approved medications. Drawing on a “patient-first” philosophy rooted in her early years at her family’s pharmacy in Ireland, Vanessa is a global scale-up expert who has led businesses totaling $2B+ across 27 markets.
