More Americans Delay Health Care - The Wall Street Journal
27 06 08 - 14:17
Cost Concerns Drive Even the Insured To Forgo Treatment - By SARAH RUBENSTEIN
An increasing array of Americans, many with health insurance, are delaying or forgoing medical care because of concern about cost, according to a report from the Center for Studying Health System Change.
About 20% of the respondents in a 2007 survey of 18,000 people said that they had put off or gone without needed medical treatment at some point in the year earlier, up from 14% in a 2003 survey.
That jump came after relative stability in patients' access to care from 1997 to 2003, according to the center, a nonpartisan policy-research group in Washington that receives funding from the Robert Wood Johnson Foundation, the Kaiser Family Foundation and the federal government, among others.
Of those who said in the 2007 survey they had scrimped, 69% cited concern about cost as a reason.
"As health-care costs increase, more of those costs are shifting to people and families," often in the form of large deductibles or other requirements that patients pay for a significant share of their care out of their own pockets, said Peter Cunningham, lead author of the report.
Mr. Cunningham said the weakening economy may have been a contributing factor to patients' behavior last year but that they also may simply have "reached a tipping point" in terms of being able to afford care amid a steady rise in medical costs.
While the uninsured reported the highest rate -- 38% -- of delaying or going without care, the biggest rate of increase in such reports was among people who had health insurance. Seventeen percent of insured respondents said that they had scrimped, which was up from 11% in the 2003 poll.
Karen Ignagni, chief executive of insurance-industry trade group America's Health Insurance Plans, said that policy makers must address a variety of issues to make the health system more affordable, including variations in quality of care and high costs associated with such things as surgery, medical imaging and numerous specialty drugs.
Tom Wirt, 65 years old, is among the insured who has delayed care.
Mr. Wirt, a small-business owner in Hutchinson, Minn., was told in 2005 that he needed surgery on his arthritic hip.
Fearing that his share of the costs would add up to thousands of dollars, he decided to wait -- and limp -- until he became eligible for Medicare coverage.
Mr. Wirt had the surgery in December and said he paid about $800 out of pocket.
Peter Koerner, a store owner in Carbondale, Pa., didn't have insurance when he accidentally sliced off half his thumb with a hydraulic wood splitter in late 2006.
When he as told that he would have to be flown by helicopter to another hospital to have it reattached, Mr. Koerner said that he knew "there's no way I could be responsible for that kind of a price tag" for the flight.
Airborne medical transports can range from several thousand dollars to tens of thousands of dollars, depending on factors such as distance traveled and the severity of the medical case, according to the Association of Air Medical Services.
Instead, Mr. Koerner said, "they basically cleaned up the wound a little bit, pulled some skin across the open wound and stitched it up." The family has so far paid nearly $1,400 of about $5,100 in bills.
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