It’s no mystery that Americans are paying a bigger share of their medical bills out-of-pocket these days. Health plan deductibles have about doubled in the past two decades. My 2023 health plan deductible is nearly $9,000. Some family plans have combined deductibles of $15,000. High deductibles are causing more Americans to delay medical care according to The New York Times.
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.
Nearly four 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 percent from 26 percent in 2021.
A recent report from the Commonwealth Fund even claims that 29% of Americans with employer-sponsored coverage are “underinsured” due to high out-of-pocket costs. The Commonwealth Fund is a left-leaning advocacy group that supports expanding government-funded health care programs. Even some Medicare beneficiaries are having a hard time affording their medical care cost-sharing.
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 that 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.
Health care’s share of gross domestic product (GDP) is nearly 20%. That suggests that one-in-five dollars goes towards health care. The problem for millions of Americans is the high cost of health insurance that provides little direct benefit, leaving nothing left in their budget to pay for cost-sharing. There are many causes of high-priced health coverage much of it is a direct result of Obamacare. Then there is the 1997 cap on Medicare-funded medical education residency slots that resulted in a physician shortage. The Federal Trade Commission has also been slow to prevent hospital consolidation, creating hospital cartels in numerous cities.
Remember the No Surprises Act against surprise medical bills? It was like pulling teeth to get the legislation passed through Congress and that was a compromise bill. Some patients still report receiving medical bills for out-of-network care they could not refuse. Government regulations benefit hospitals by paying them more for the same services that can be obtained elsewhere cheaper. That makes it lucrative for hospitals to buy physician practices and employ doctors, since hospitals get reimbursed higher than private practice physicians do for the same service. As a result of these perverse incentives, more than half of doctors now work for hospitals.
Hospitals are the most expensive place to receive medical care. Yet many Americans are forced to see physicians whose charges are higher due to hospital employment. Some of these physicians are also rewarded (or punished) for the number of internal referrals they arrange. There is little price transparency allowing consumer to compare prices in and outside the hospital. Yet millions of Americans are probably willing to compare prices if they just had the tools and realized that it’s possible. The competition created by encouraging patients to shop around would do wonders for prices and consumers’ wallets.
1 thought on “More Americans Delay Care Due to Cost”
There was a school of thought several years ago which speculated that if patients declined to purchase medical care because of cost, this might actually be a good thing.
The reasoning was that much medical care was overpriced and even superfluous, and if patients declined it then providers would have to lower their prices.
I see no evidence that providers are lowering their prices. As this post documents, hospital consolidation raises prices much faster than consumer choice can lower them. Drug companies to my knowledge never lower their prices by 5 cents if consumers protest.
The original school of thought left us with the image of a bored surburbanite deciding not to have an MRI after hurting his back playing basketball. We certainly were not shown the image of a 71-year old woman in great pain because she declined to buy some wildly overpriced chemotherapy.
I have felt for years that we can divide health care procedures into voluntary and involuntary care. The consumer-choice policy changes might work well for voluntary care….but they can be cruel and ineffective for involuntary care.