Co-payments, deductibles, over-the counter products and care provided to others all constitute hidden costs of healthcare, a U.S. health economist says. Paul Keckley, executive director of Deloitte Center for Health Solutions in Washington, said many people who get health insurance from their employer are often lulled into thinking their healthcare is not costing them but in reality, the average U.S. household spends 19.8 percent of discretionary income on healthcare -- more than for transportation or food. "For the 169 million people in the United States with employer-sponsored insurance coverage, the majority of premium increases expected in 2012 -- the range is 7 percent to 17 percent, depending on company size and plan, according to America's Health Insurance Plans -- will be passed through via increased co-payments, reduced benefits, or coverage dropped altogether," the report by Deloitte Center for Health Solutions said. For those in Medicare and Medicaid, increased enrollment with fewer tax dollars to cover services means less access and more cost-sharing unless structural changes are made in each program, Keckley said. "For those without coverage -- 50 million and increasing -- it means the system will be less accessible, public health programs strapped and increased pushback from employers unwilling to pay a hidden tax to subsidize coverage for employers who do not insure their employees and individuals that choose to take their chances," Keckley said. "The cost of the health system is embedded in every item we buy. But it is virtually invisible to most consumers because it's hidden in indirect pass-throughs, piece-meal co-payments, and transfer taxes from those who don't pay to those who do."