“When you fully understand the situation, it is worse than you think,” Barry Commoner, a pioneering environmentalist, quipped 50 years ago. Today, it’s applicable to policy wonks’ depictions of healthcare affordability. According to surveys, only a small fraction of Americans — about one in 10 — incur crushing healthcare bills. Yet, unaffordability is Americans’ top healthcare concern. New research we published in December helps explain that disconnect.