Higher bills lead many to delay medical care
Nearly 40% of Americans say they put off care in 2022 due to cost
Megan Swanson has warily watched the erosion of her family’s savings as inflation chips away at a reserve for emergencies. She often postpones any regular doctor’s appointments, including her yearly dermatology appointment, even though annual skin checks are typically recommended for residents of sunny Florida, where she lives in Naples with her husband and their three children.
“Each month we are seeing our costs go up, but not our bank account,” she said.
Swanson, 37, is a part-time student and has not worked since she was laid off during the pandemic when the local Nordstrom store closed in 2020. Her husband, Brett, 37, is employed as the director of wellness at a retirement community.
“I put the priority on the kids,” she said. In March, the Swansons had to come up with $8,000 to cover their share of hospital bills after their baby daughter was hospitalized with a febrile seizure. “What if something happens again in the future, and how will we afford it?” she asked.
Rising out-of-pocket costs are weighing heavily on the scale, pushing aside tests or procedures when troublesome symptoms emerge. And these days, the grocery list (and even the price of eggs) feel more pressing to many families. While some people avoided seeking medical care during the worst of the pandemic, worried about the risk of infection or unable to get an appointment because hospitals and doctors were overwhelmed, now many are finding that inflation and the uncertain economy have thrown up another barrier.
“We are starting to see some individuals who are putting off some care, especially preventive care, due to the costs,” said Dr. Tochi Iroku-Malize, the president of the American Academy of Family Physicians and the chair of family medicine for Northwell Health in New York. Choosing between going to the doctor or paying for rent and food, “the health issue is no longer the priority,” she said.
The inability to afford medical tests and treatment, a perennial concern in the United States, began emerging as a much more striking issue last year. Nearly 4 of 10 Americans said they had put off care in 2022 because of cost, the highest number since Gallup started asking people about delaying care more than 20 years ago. The percentage reporting they or a family member delayed health care because of cost rose to 38% from 26% in 2021.
With the prices of prescription drugs, hospital stays and other treatments expected to increase significantly this year and next, some doctors expect families to have an even harder time affording medical care. A recent report from the Commonwealth Fund found 29% of people with employer-based coverage were underinsured because they had such high out-of-pocket costs even with insurance. The coming roll back of health coverage under the state-federal Medicaid program will very likely lead many people to become uninsured.
About one-fourth of respondents in Gallup’s poll said they put off care last year for what they considered a “serious” condition. When Margaret Bell, 71, found her cancer had returned four years ago, she hesitated to resume her chemotherapy because she could not afford it, and higher prices have made it even harder. She would regularly skip appointments near her home in Lancaster, S.C.
“It is impacting patients’ access to care,” Bell’s oncologist, Dr. Kashyap B. Patel, said. As the chief executive of Carolina Blood and Cancer Care Associates in Rock Hill, S.C., he recently set up a nonprofit group, No One Left Alone, to help cancer patients like Bell and to connect them with local charities. The organization is covering the cost of her treatments, and Patel has assured her his office will find the money for her visits.
On a limited budget, “it’s been very difficult for me,” Bell said. Having her family over for dinner can be a strain because of high grocery bills, and she is faced with deciding which of her medical needs is the most urgent. She has postponed receiving a pacemaker.
A new federal report suggests fewer Americans’ health bills are being sent to collection, but medical debt still accounts for more than half of all kinds of collection debt, exceeding unpaid credit card or cellphone bills. It remains a serious issue: about a fifth of Californians said they had medical debt of at least $5,000, according to another recent survey. A little over half of those asked said they had skipped some kind of care in the last year, with half of those reporting their condition got worse as a result.