The financial strain of paying for health care in the U.S. has been made clear by a new survey that shows that Americans borrowed an estimated $88 billion in 2018 to pay for medical attention. The survey, released Tuesday by Gallup and the nonprofit West Health, shows that around a quarter of Americans avoided seeking treatment for medical problems because of the costs, and that half of the adult population fears a medical emergency could bankrupt them, The New York Times reports. Only 39 percent of respondents said they were satisfied with how well the system was serving Americans generally. “Our data shows an American public that’s beaten down from this really serious issue,” said Dan Witters, a senior researcher at Gallup. However, 64 percent of respondents said they were mostly satisfied with their experiences in the health-care system.