September 2007
How to pay?
Consumers faced with higher health costs have to find the money somewhere, and many in our survey found that tough to do.
Overall, 37 percent said their health insurance and checking accounts together weren't enough to pay for their medical expenses
over the previous year. But 59 percent of underinsured respondents fell in that category. They had to raid their retirement
accounts, run up credit-card balances, and borrow from friends and family to pay their medical bills. Twenty-seven percent
said they were still in debt to doctors and hospitals, and 3 percent said medical bills had forced them to declare bankruptcy.
Almost 4 in 10 underinsured respondents deferred needed auto or home repairs. Almost 3 in 10 said they made decisions such as changing jobs, postponing retirement, or changing their marital status mainly to preserve access to health insurance.
Roy Allen, 60, of Tallahassee, Fla., would be happy to retire right now; after 41 years with his telecommunications employer, he is eligible for full pension benefits under his union contract. But he has calculated he can afford only three years' worth of retiree health insurance before going on Medicare. "My wife has never worked outside the home, so her insurance is through me," Allen says. "She has a lot of minor health issues that require frequently going to the doctor and lots of medication."
But the most worrisome result of underinsurance is reduced access to health care itself. Forty-three percent of underinsured respondents said they had postponed going to the doctor because they couldn't afford it, and 28 percent had put off filling prescriptions.
Mary Sparnes, a 60-year-old homemaker from rural Gladstone, Mich., was wheezing during a recent telephone interview. "I'm diabetic and have Crohn's disease, Meniere's disease, and arthritis," she says. "My husband has high blood pressure, ulcers, arthritis, borderline diabetes, and he's got a new hip and a new knee. And we both have asthma."
Their health plan, which costs $390 a month through her retired husband's former union, eats up nearly a quarter of their monthly income and also comes with a 20 percent coinsurance for doctor visits and a $20 co-pay for generic drugs ($40 for brand names).
"The collection agency here in town is very nice," Sparnes says. "I've just told her right out that I can pay $3 to $5 a month, and she says that's OK. As far as the asthma inhaler, I don't take that unless I can get a sample from the doctor."
Such delays can have big consequences. A nationwide study of 2,498 patients who had had a heart attack found that those who said they had a tough time paying for health care, 18 percent of the total, were in markedly worse shape a year later. Compared with people with adequate health resources, they were more likely to have been rehospitalized and to have angina. Authors of the study, which appeared in the March 14, 2007, Journal of the American Medical Association, said that inability to afford medications was to blame for much of the disparity.
Almost 4 in 10 underinsured respondents deferred needed auto or home repairs. Almost 3 in 10 said they made decisions such as changing jobs, postponing retirement, or changing their marital status mainly to preserve access to health insurance.
Roy Allen, 60, of Tallahassee, Fla., would be happy to retire right now; after 41 years with his telecommunications employer, he is eligible for full pension benefits under his union contract. But he has calculated he can afford only three years' worth of retiree health insurance before going on Medicare. "My wife has never worked outside the home, so her insurance is through me," Allen says. "She has a lot of minor health issues that require frequently going to the doctor and lots of medication."
But the most worrisome result of underinsurance is reduced access to health care itself. Forty-three percent of underinsured respondents said they had postponed going to the doctor because they couldn't afford it, and 28 percent had put off filling prescriptions.
Mary Sparnes, a 60-year-old homemaker from rural Gladstone, Mich., was wheezing during a recent telephone interview. "I'm diabetic and have Crohn's disease, Meniere's disease, and arthritis," she says. "My husband has high blood pressure, ulcers, arthritis, borderline diabetes, and he's got a new hip and a new knee. And we both have asthma."
Their health plan, which costs $390 a month through her retired husband's former union, eats up nearly a quarter of their monthly income and also comes with a 20 percent coinsurance for doctor visits and a $20 co-pay for generic drugs ($40 for brand names).
"The collection agency here in town is very nice," Sparnes says. "I've just told her right out that I can pay $3 to $5 a month, and she says that's OK. As far as the asthma inhaler, I don't take that unless I can get a sample from the doctor."
Such delays can have big consequences. A nationwide study of 2,498 patients who had had a heart attack found that those who said they had a tough time paying for health care, 18 percent of the total, were in markedly worse shape a year later. Compared with people with adequate health resources, they were more likely to have been rehospitalized and to have angina. Authors of the study, which appeared in the March 14, 2007, Journal of the American Medical Association, said that inability to afford medications was to blame for much of the disparity.
