What’s the largest single barrier to job growth in the U.S.? According to Gallup Chairman Jim Clifton, writing in The Coming Jobs War, it’s healthcare. “It is impossible for the U.S. to win the race for new good jobs while the country continues its failed strategies for healthcare,” he says. “The United States has to fix [healthcare costs] or it shuts off the energy switch to entrepreneurship and innovation. If this happens, everything else ceases to matter.”

The size of the problem is nearly inconceivable. People look at their own healthcare costs and see the price creep. They look at the growing cost of co-pays and the ever-increasing cost of medication. Many people have elderly relatives who have spent time in hospice or in nursing homes.

But most people never even consider the huge numbers that workers’ comp claims add to the yearly cost of healthcare. The total cost to America is even larger than the numbers, though. According to Clifton, its costing us our competitiveness.

Healthcare costs America $2.5 trillion a year. […] The problem with healthcare costs is that they’re accelerating. They’ll grow from $2.5 trillion to $4.5 trillion within 10 years because they’re growing at about 6% a year. So if we can’t get that fixed, organizations won’t be lean enough to grow or to do other things they need to do, like export. Healthcare costs have become the biggest problem that companies have — or cities, counties, states, and the federal government. Nobody can afford healthcare. This is the biggest barrier to job creation that America has.

Clifton cites two main reasons for the increasing cost of U.S. healthcare.

First, obesity is at epidemic rates, and so are the problems it causes, like diabetes. Second, we spend enormous amounts of money with no limits or caps on our last six months of life. Seventy percent of the money we spend on healthcare in the U.S. is on things that are preventable.

Clifton’s solution? He recommends a cultural shift in the conversation about obesity, likening it to the way America went after cigarettes, and a real hard look at the way we care for the sickest and oldest among us. Read more about it here.