Very real health care costs not a fictional Grinch are taking away holiday cheer from more than half of Americans.

Fifty-three percent of individuals say health care bills have eaten into money they would have otherwise spent celebrating the season, according to a survey from insurer Aflac. Sacrifices they've made include cutting back on or forgoing altogether traditions like gift-giving and travel. They also say they're borrowing money from friends or relatives and working extra hours, just to keep themselves healthy.

"Health care costs are affecting Americans' financial security, particularly around the holidays," said Aflac's Stephanie Shields.

The share of families with kids whose medical costs have led them to make a "sacrifice or hard decision" is even higher. Seventy-one percent said doctor's office visits and other medical expenses have hamstrung their holiday spending during the past two years.

Shields attributes the financial burden to high out-of-pocket expenses. Nearly 30% of families with kids who visited a hospital in the past two years said they spent $1,000 or more in out-of-pocket costs, according to Aflac.

"One of the themes is medical expenses outpacing the amount of insurance people have," Shields said. "They are beyond what co-payments or deductibles will cover and that results in greater out-of-pocket costs."

Some of those families that are struggling to keep up are opting for health care rather than holiday gifts. Nearly 1 in 4 families said they spent less on gifts during the past two years, and 1 in 5 decided against purchasing a gift for a loved one altogether, according to the survey.

Medical costs also affect how people finance their pared-down spending. Nearly one in five families chose to finance paying for holiday events, travel and gifts with credit cards, and more than one in four say they borrowed money from a friend or family member. Twelve percent of families with kids said they took out a loan in order to finance the holidays because of medical costs.

Also sobering: Medical costs are influencing when and how individuals access healthcare, all throughout the year. Thirty-five percent of families said they postponed their own medical appointments due to cost concerns, the survey found.

A recent Gallup poll found a record 25% of Americans said they or a family member delayed treatment for a serious medial condition because of cost, up 19% from a year ago. Another 8% put off treatment for a less serious medical condition.

Shields stressed the importance of families paying close attention to the details of their insurance plans and to select a plan with benefits that fulfills their needs. After all, 42% of families with children say they've made mistakes in choosing coverage or seeking out care.

She encourages families to review their plans' benefits annually and adjust selections based on evolving needs, as well as to make the most of flexible spending accounts and other services available through insurance plans like telemedicine, which can help lower costs.

"Health care costs are a continuing financial burden to families and they need to decide how to spend their dollars. Ultimately, we don't want to see Americans go further into debt over this," she said.

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High health care costs limit Americans' Christmas and holiday spending - CBS News