U.S. consumers have a widespread appreciation that our healthcare system is overly expensive, but there is little understanding of who is being victimized by these high costs and how their burden is imposed. The frequent stories in the media about individuals being hit with outsized medical bills feature people of every age and from all walks of life. But the analysis developed here and documented with data shows that it is the working-age population covered by private insurance—including those covered by insurance from their employers, especially lower-earning workers—who are most burdened by the system's high costs. It also shows that most members of this group do not fully grasp the price they are paying for their health care, as a sizable share of the costs are imposed in the form of lower take-home pay. The combination of the high costs and their hidden nature has acted as a tremendous drag on workers' wages, leaving them less able to afford all the other things they need and want, such as educating their children, saving for retirement and buying a home. Our healthcare system is effectively a cancer on the American Dream. The analysis goes on to show how various segments of the health delivery system impose higher costs on the working-age population with private insurance than on those covered by Medicare, Medicaid and other public insurance plans. After presenting the evidence on whom and how the U.S. healthcare system exacts its high prices, the latter part of the analysis sets out alternative ways and policies that could reduce costs over time and lighten the disproportionate load imposed on workers and their dependents.