Poor Americans risking financial ruin with their health might be surprised that even the rich worry about affording the rising cost of health care in the United States. But a new survey from U.S. Trust shows poor planning and anxiety on behalf of many Americans with more than $3 million in investable assets.

“It's the gorilla in the room," Chris Heilmann, U.S. Trust's chief fiduciary executive, told CBC. "There's an understanding of the increasing expense of health care, and there's an understanding of longevity."

Sixty percent of those surveyed said they’d had to pay expenses for a relative, suggesting more affluent Americans might too be tied to economic realities further down the socioeconomic ladder. "While the survey doesn't specifically say it's necessarily health-related… we believe it is," Heilmann said. "About 37 percent are saying that they are doing it at the expense of perhaps obtaining their own financial personal goals," Heilmann said.

In a country with the world’s most expensive health care system, even wealthy Americans worry about the financial risk of long-term health requirements that might seem endless for some. Aside from routine health care expenses, Genworth Financial says long-term costs continue to rise in the U.S. The median national cost of assisted living rose 1.45 percent from last year to $3,500 per month, while the daily rate for nursing home care rose 2.62 percent to $212.

Although Medicaid in many states pays expenses for long-term care costs including nursing home care, the worried wealthy rightly fear spiraling out-of-pocket costs should they or a relative require expensive care. As the Baby Boomer generation ages further into retirement, more than 80 million Americans will soon find themselves at greater financial risk. Genworth says at least 70 percent of elderly people will require long-term care services at one point or another.

Thus, Americans with assets to protect should plan for a financial future that considers the rising costs of long-term care.

"To provide the financial resources for the eventual need from a health care standpoint, or a living longer standpoint — it can't be a one-string guitar,” said Heilmann. “It needs to be looked at on a tailored basis.”