You’ve been watching the presidential campaign, so you can’t miss the references to Obamacare. It’s a significant component of the rhetoric for all the candidates. Hillary wants to add to it, Bernie wants a “Medicare for All” program, and Trump wants to repeal it altogether. We haven’t heard much else about healthcare from the candidates.

But there’s a lot more confronting us than Obamacare. Americans are facing some critical health care issues that will impact their lives.

Consider out-of-pocket spending. Although millions more people have health insurance thanks to the Affordable Care Act, most individuals are paying more of their medical bills than ever before. Employers are also feeling the pinch of rising health care costs and are passing some of them on to employees in the form of increased premiums, deductibles and out-of-pocket costs. Often these costs are rising faster than wages. Those who are buying coverage through the ACA’s health insurance exchanges are finding that their costs associated with even the richest plans render them unaffordable.

We’ve heard the candidates talk about the price of prescription drugs. Rising drug prices are an increasingly bigger problem for patients. Drug companies tell us that the cost of drug development impacts the expense to the consumer. What happens when insurance doesn’t cover prescriptions and the out-of-pocket is too much for the individual?

And then there’s long term care. Every day, 10,000 baby boomers turn 65 and qualify for Medicare. An estimated 70 percent of those who reach age 65 will need some sort of long term care. And those of us who have had experience with long term care know it’s not cheap. Although Medicare does have some nursing home and home care benefits, they are temporary and limited to specific medical needs. Most people who need long term care need simple care with what is considered “activities of daily living”. In addition, long term care insurance is very expensive and has become more difficult to find as there are fewer insurers who underwrite it.

Lack of dental care continues to be a problem. According to the Centers for Disease Control and Prevention, one in every three adults has untreated tooth decay. The same reports says that more than 100 million Americans don’t have dental insurance. Also 38 percent of adults aged 18-64 reported no dental visits in 2014.

There is a lot on the horizon in the world of health care. It goes way beyond Obamacare.