It’s something that doesn’t get the attention it deserves in this health care debate, in large part because the true cost of health care is hidden from most people. (Though those of us fortunate enough to have employer-provided health coverage do get an eye-opening, jaw-dropping reminder during our annual open enrollment period, which we happen to be in here at TIME. I think I’m speaking for all my colleagues when I say, it’s not pretty.)

But Rob Shapiro, who was a top economic adviser during the Clinton Administration, puts the cost of doing nothing in a perspective that is easy to understand. According to Shapiro, if things keep going the way they are headed, the typical middle class family could find itself paying one-third of its income for health care within five to six years. Here’s how Shapiro does the numbers, based on analysis by Urban Institute economist Eugene Steuerle: