The affordability of health care is a major issue drawing fierce debates across America. According to Gallup, in 2019, 33 percent of Americans said they or their family put off treatment for a medical condition due to high costs, and 25 percent said they delayed looking into a serious condition.

The rate of postponing medical care was the highest in the past 20 years. Meanwhile, a report by Rx Savings Solutions said the prices of 3,400 types of prescription drugs went up by 10 percent from the year before, five times the rate of inflation.

To buy insulin at a tenth of the price it would cost in their own country, some in Minnesota need to travel 1,300 kilometers north to Ontario, Canada.

The drug is a life saver for those suffering from Type 1 diabetes. 

"It is staggering how much more money it is in America. You can see why one in four Americans are rationing their insulin because they cannot afford it. We are from a wealthy country. We are from a great country, but we are not taking care of our citizens," said Quinn Nystrom, an advocate for people with diabetes.

John Kenned, who has diabetes, said: "This [medicine] retails for around 300 dollars for one vial [in the U.S.]. And I just got it for 25 U.S. dollars here [in Canada]. Now why the hell is that? Why? It's crazy to me. So as excited as I am to save some money, I am devastated to know that affordable insulin is just available to us across the border."

There is also anger that people continue to die from diabetes because they couldn't afford proper treatment.

"Here we are talking about how even though there's a treatment for Type 1 diabetes, my own son didn't benefit from that treatment because he couldn't afford it. It's difficult. It's a hard pill to swallow," said Nicole Smith-Holt, whose son died in 2017 because he was rationing insulin.

The American Journal of Public Health suggests health issues have led to two-thirds of bankruptcies in the U.S. Its report looked at a thousand cases between 2013 and 2016, and it found a majority of those who had trouble paying medical bills were middle-class Americans who had health insurance.

A Gallup report says between 2016 and 2018, seven million Americans lost their medical insurance and 21 percent under the age of 35 were uninsured. Health care, or the lack of it, has become a key factor that divides the rich and the poor.

The U.S. Census Bureau says the income gap is at its largest in 50 years. It's measured through the Gini index, with zero representing total equality and 1 representing total inequality. 

In 1967, the Gini index was 0.397. In 2018, it climbed to 0.485. By comparison, no European nation had a score greater than 0.38.

In 2018, the top 10 percent of U.S. households controlled 70 percent of all wealth, up from 60 percent in 1989. Meanwhile the share controlled by the top one percent of wealthy Americans went from about one-fifth to nearly one-third.

Those at the bottom half of the wealth distribution saw virtually no increase in their nominal net worth over the last 30 years, while their total share of national wealth dropped, from four percent to just one percent.

While half a million homeless people are without a roof above their heads every night and four in five working class Americans are living from paycheck to paycheck, a potentially record-setting amount of money is being poured into the 2020 presidential election campaigns by wealthy donors and powerful political forces.