Jeffrey S. Barkin, MD, DLFAPA, is a practicing psychiatrist in Portland and the former president of Maine Medical Association. He co-hosts “A Healthy Conversation” on WGAN.

Most of us do not think much about health insurance until we need it. It is like the roof over your head. You do not look at it every day. But you notice the first leak. In America, many families are hearing those first warning drops right now. And unless we act, the whole ceiling may give way.

This is not a Republican problem or a Democratic problem. Getting sick is not partisan. Losing health insurance is not partisan. Bankruptcy is not partisan. Illness does not check who you voted for, how you feel about Congress, or whether your state is red or blue. When a child spikes a fever or a parent hears the word “cancer,” politics fall away. Only people remain.

But people are in trouble. Federal health-insurance subsidies — the support millions of working families rely on to afford coverage — are at risk of being lost. If these subsidies disappear, the consequences will ripple through homes, workplaces, towns and the entire economy.

Start with the hard numbers. The average price of health insurance for a family has now reached $27,000 a year. The average cost of health care in this country is more than $14,000 per person per year. These numbers are so large they barely feel real. But families feel them. The math is brutal. Without subsidies, millions of Americans simply cannot pay for coverage. They will drop it because they have no choice.

And when people drop coverage, something dangerous happens. The healthier individuals — those who do not go to the doctor very often — leave first. That leaves mostly people who are already sick. When the insurance pool gets sicker, premiums rise. When premiums rise, more people drop coverage. Then premiums rise again. It becomes a cycle that speeds up as it spins. Economists have a name for this. It is called a death spiral. It is every bit as bad as it sounds.

Let me tell you about a man I will call Robert. He is a 44-year-old father from central Maine who works two part-time jobs because neither offers benefits. He buys his health insurance on the federal marketplace. Even with subsidies, it takes a big chunk of his paycheck. One fall afternoon, he climbed a ladder to clean his gutters. The ladder shifted. He fell hard, felt a snap in his leg and landed in the grass gasping. His kids rushed outside. But the first thought in his mind was not about pain or the break. It was: “How much will this cost?”

Think about that. A father with a broken leg, scared and hurting, was more afraid of the bill than the injury. Without subsidies, his premiums would be higher than his mortgage. Dropping coverage would not be a decision — it would be survival. The next fall could cost him his home, his job, or his future.

I also think about a young woman I will call Marissa. She is 27, works in retail and has Type 1 diabetes. Her insulin and diabetes medications are not optional. They are life-sustaining. Even with subsidies, her premiums strain her small paycheck.

One month, her hours were cut. She sat at her kitchen table with a stack of bills and a calculator. Something had to give. She chose to stretch her medicines by taking a little less every day. Her blood sugar crept up, then shot up. She collapsed at work and woke up in the emergency room with diabetic ketoacidosis — something that can kill a person within hours. She cried when she saw the nurses. Then she cried again when she saw the bill.

If subsidies go away, she will lose her health insurance. And without it, she may lose far more than money.

Stories like these are all around us. They do not appear in campaign ads. They do not trend on social media. But they are happening in silence, one family at a time.

Medical bills are already one of the top causes of bankruptcy in the United States. When people lose coverage, they start skipping check-ups, blood pressure checks, mental-health visits and preventive care. Small problems become big problems. Big problems become emergencies. Emergencies become debt. By the time the bill arrives, the damage is done.

Some people say they can shop around for cheaper plans. Others say they are young and healthy and can do without insurance. Some say their job gives them great benefits and they are safe. But illness does not knock politely. It does not schedule itself. It does not wait for open enrollment.

A stroke, a car accident, a new diagnosis, a sudden infection — these things do not care about your job, your politics or your plans. And when the bills roll in, families suffer in the same ways. They take out second mortgages. They drain retirement accounts. They skip medicine. They avoid the doctor. They pray that luck holds.

We already spend nearly 18% of our entire national economy on health care. Nearly one out of every five dollars earned in America goes toward medical care. No other wealthy nation spends this much, and many get better results. It is not sustainable for families or the country. Something has to give. But it should not be people’s health.

The fear, stress and financial strain caused by losing health insurance reach into every corner of life. Parents put off their own care to protect their kids. Young adults go without needed medicine. Older adults cut pills in half. People take on extra work at the cost of their health. Some lose their homes. Some lose their futures. Some lose their lives.

And yet, there is still a way forward. We can choose a different path. Americans have always been at our best when we confront big problems with courage and honesty. We do not look away. We do not give up. We roll up our sleeves and fix what is broken.

We can protect the subsidies that keep working families insured. We can support policies that make health care more affordable, not less. We can decide that no American should go bankrupt because they got sick. We can build a system that cares not only for emergencies, but for prevention, chronic illness, mental health and aging with dignity.

We do not need a miracle. We need will. We need decency. We need to remember that we are all made of the same fragile things, and illness is the great equalizer.

If subsidies disappear, the death spiral will not just be an economic term. It will be a human story of fear, suffering and preventable loss. It will be a terrible unforced error. But the good news — the hopeful news — is that we are not there yet. The roof may be leaking, but it has not collapsed.

We can still act. We can still choose compassion and common sense. We can still protect families like Robert’s and Marissa’s. We can still say that health care in America should be about healing, not about fear. We can still choose a future where getting sick does not mean going broke, and where health insurance is something families can afford without losing sleep.

We are better than a death spiral. We are a country built on helping neighbors and solving hard problems. And it is never too late to do the right thing.