NOT long ago, a 23-year-old woman joined my company as an assistant in the advertising sales department at a starting salary of $35,000. Smart, ambitious and poised, she should have a promising future. Unfortunately, her earnings prospects are threatened. Like many Americans, she’s unaware of how much of her compensation is being eaten up by health care costs, and how much this share will grow as long as the increase in health costs exceeds growth in gross domestic product. That’s just math.

The Affordable Care Act does require employers, beginning this year, to note on W-2’s how much both the employee and the employer contributed to health care costs. Maybe that will help diminish the ignorance regarding true health care costs. But even with greater awareness, many Americans still might not understand that the largest effect of the cost of our health care system is to reduce the amount of money they actually take home.

I have estimated that our 23-year-old employee will bear at least $1.8 million in health care costs over her lifetime. That’s assuming that such costs don’t grow by more than current government estimates, that she never has a working spouse, and that she and her dependents don’t ever contract a serious illness.

Even after decades of financial engineering, including both the already-implemented and the planned aspects of the Affordable Care Act, the American health care system can be called successful mainly in its ability to hide its enormous cost.