Our deep dive into the items listed in the December 2025 USA Today News article’s American Dreams List wraps up with four final examples of a larger point: dreams become healthier and more durable when they are treated as intentional financial choices, not automatic milestones.

Healthcare ($414,208 Lifetime Cost)

Most of us would consider healthcare—like many of the other items on the dreams list—an essential part of life rather than a dream. That distinction matters because essential costs must be planned for with discipline, not romanticized as optional aspirations.

Having worked 33 years as an insurance professional, I place health care expenses in three separate categories:  Out of Pocket, Risk Transfer, and Pre-Paid.

Out of Pocket.

Healthcare at its core is a lifelong responsibility to maintain personal health. Doctors, hospitals, and health insurance all play a role, but they cannot replace daily choices such as nutrition, movement, lower-toxin products, and a healthier home environment. Many of these costs are predictable out-of-pocket investments that should be planned for before they become crisis expenses.

Risk Transfer.

Insurance is a financial risk transfer instrument designed to protect against catastrophic, unanticipated loss. Expecting insurance to absorb every routine, known expense can make coverage unaffordable and distort its purpose. Health insurance is most workable when it protects against major unexpected medical costs while families budget separately for regular care.

For example, some maintenance treatments recommended by my providers are not covered by my health insurance, so I treat them as planned out-of-pocket expenses rather than risks to transfer. I prefer to use insurance for its intended purpose while still making informed care decisions with trusted health professionals.

Pre-Paid. 

Long term care and catastrophic illness plans are the most popular forms of pre-paid health related plans.

A final word about healthcare: the real dream is fulfillment in later years of life—for both the individual and the immediate family. Health is as important to a satisfying retirement as wealth, and the best results come from continuous, consistent care throughout adulthood rather than delayed dependence on insurance alone.

Annual Vacations.  ($180,621 Lifetime Cost) 

We might argue that vacations are necessary for mental and emotional health and therefore belong, at least partly, within the broader idea of health care. Fortunately, vacations are one part of the American Dream that can be downsized or expanded to fit family finances without losing their purpose. A “staycation” captures the idea well: time away from work spent resting, exploring, or enjoying leisure close to home rather than spending heavily on distant travel. Benefits of staycations include:

  • Saving money by avoiding expensive tickets, gas, hotels.
  • Reduced stress from packing, airport lines, traffic jams.
  • Increased comfort from sleeping in your own bed.
  • Eco-friendly by reducing carbon footprint.

Annual vacations are one dream that can shrink or expand to fit the finances of the moment and still retain much of its intended benefit. 

Pets.  ($39,381 Lifetime Cost)

That this one made the dreams list is, perhaps, no surprise, but the lifetime earnings spent on pets still deserves careful consideration. For some households, pet ownership brings real companionship and joy; for others, the costs may compete with food, housing, debt repayment, savings, or even decisions about children. Without rendering judgment, I am simply highlighting that pet ownership is a financial commitment, and this dream, like all others, must be considered with wisdom and clarity.

Weddings.  ($38,200 Lifetime Cost)

My personal experiences leave me cautious about speaking for everyone on this topic, so I will offer a few examples that point to the same financial principle: weddings can be meaningful without becoming financially burdensome.

My first wedding, in 1974, was held at my parents’ home with a few close friends and church members gathered in a small living room. I made my own wedding dress and dresses for my mother and sisters, the pastor accepted a $50 gift for his services, and cake and refreshments were served in my mother’s kitchen. It was simple, personal, and complete.

My second marriage was even simpler. We were broke, in debt, and disappointed with previous marriages, so we took a couple days off work, drove to Tyler, Texas, spent an afternoon in the rose gardens, found a justice of the peace, and got married. Forty years later, we have no regrets.

A friend who is father of five girls began saving for weddings early.  Each daughter knew the exact amount she would have in her wedding account.  She was given the option to spend the funds on a wedding and honeymoon, as a down payment on a house, or as savings to begin her newly married life.  But she would get no additional funding from her father.

A co-worker announced that her sister’s wedding had cost $40,000 as she planned one of her own that would cost even more, hoping her father was prepared!

Needless to say, weddings are an element of the dream that can be planned and managed to great satisfaction. This item should never require long-term debt. 

Defining Dream

In conclusion, I want to return to the definition of “dream.” It includes many beautiful elements, but one part is particularly instructive: “a state of mind in which someone is unaware of their immediate surroundings.” These discussions of the American Dream are meant to keep us awake to the financial landscape around us so we can craft our dreams deliberately, pursue them wisely, and enjoy them without being overtaken by their cost.

Read more of Gail’s article on Plaid or connect with her on her website.