Americans have reduced their doctor visits, per suvery
13 08 08 - 14:19
22% of Americans surveyed cut visits to doctor
by Victoria Colliver, Chronicle Staff Writer
Nearly a quarter of Americans have reduced the number of times they see their doctor because they want to save money in these tough economic times, according to a survey released Tuesday by the country's state insurance regulators.
The poll of 686 consumers, fielded in July for the National Association of Insurance Commissioners, found that 22 percent of respondents weren't visiting the doctor as often as a result of today's economy.
Eleven percent of those surveyed also said they had cut back the number of prescription drugs they take or the dosage of those medications to make the prescription last longer.
Some physicians noted an increase in such behaviors by their patients and were concerned about potential health consequences.
"There's a lot of evidence that the more patients are required to pay more for their care, the more that they make economic decisions about what to get or what not," said Dr. Michael Potter, a family physician at UCSF Medical Center and head of the San Francisco chapter of the California Academy of Family Physicians. "While some of that may be perfectly reasonable and acceptable, what I worry about is people not getting care that is really essential for their health."
Americans have been paying a greater share of their health care costs over the past several years primarily because employers, who cover nearly 60 percent of insured individuals, have been shifting more of the rising cost burden onto them by requiring them to pay a larger share of the premium, raising co-payments, changing plan designs and reducing benefits.
Some of those tactics are designed to make people think twice before running to the doctor, particularly high-deductible plans that require large out-of-pocket spending before more comprehensive coverage kicks in. The idea behind such plans is that consumers who have more skin in the game will spend those dollars more wisely.
But officials who regulate state insurance practices said they're concerned that as times get tougher, an increasing number of insured will forgo necessary care and possibly incur greater costs down the road due to delays in treatment.
"Yes, we know when people have comprehensive health insurance, they have a tendency to overuse and access that care more than they absolutely need," said Sandy Praeger, president of the insurance commissioners' group and insurance commissioner for the state of Kansas. "A little bit of discipline may be all right, but I would want to err on the side of making sure they can get sufficient care."
The survey also asked people whether they have made changes to their health policies. The vast majority - 85 percent - said they had not, a percentage Praeger said was not surprising, given that most plan decisions are made by the employer. Only 2 percent said they had canceled their coverage entirely.
Because the regulators' association has not done a similar survey in the past, it's difficult to track any change in consumer behavior. And the survey didn't delve into details behind the respondents' decisions.
"We know from past economic downturns that employers and individuals tighten their budgets as a whole, but they certainly tighten their health budgets," said Chris Ohman, chief executive of the California Association of Health Plans. He noted even though health costs have increased two to three times the rate of inflation for years, the pinch feels greater as the economy worsens.
Tips to lower your health insurance costs
-- Stay within the insurer's network of doctors and hospitals whenever possible, and make sure to get any necessary referrals or preauthorizations for care.
-- Keep all receipts for medical services, whether in- or out-of-network. In the event you exceed your deductible, you might qualify for a tax deduction for out-of-pocket medical bills.
-- Consider opening a flexible spending account, if your employer offers one, which allows you to set aside pretax dollars for out-of-pocket medical expenses.
-- For spouses who both work at jobs that provide health insurance, compare policies and costs to see which one best fits your needs. Look beyond the monthly premium and evaluate covered services, co-payments and deductibles.
-- For additional help and information, contact the California Department of Insurance at (800) 927-4357 or online at www.insurance.ca.gov. People covered by health maintenance organizations should contact the state Department of Managed Health Care's HMO Help Center at (888) 466-2219. The department's Web site is www.dmhc.ca.gov.
Source: National Association of Insurance Commissioners, Chronicle research.
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