Affordability is Critical to Health Care Reform

Reinforcing the need for comprehensive health care reform, a recent survey indicates that Americans, even those with health insurance, increasingly delay or forgo medical care due to cost concerns.  This survey, conducted by the Center for Studying Health Systems Change, is the latest indication that affordability is key to any approach to reform.

Indeed, this report confirms the findings of CHW’s 2008 Health Security Index which found that 24% of Americans have had to choose between paying for basic necessities (such as groceries or heat for their homes) and health care. 

Sarah Rubenstein describes the report from the Center for Studying Health Systems Change in her article for the Wall Street Journal.

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.

Moreover, Rubenstein shares a vivid example of the impact that delaying care can have on Americans.

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.  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.

These people in these stories are real.  Their problems are real.  The implication is clear: rising costs resulting from the American health care system force decisions that potentially threaten the well-being of thousands, if not millions, of Americans.  What role do providers (doctors, hospitals, insurance) have in addressing this issue?  What role do patients have?  Does the government have a role to play?

Comments

[Toronto life insurance broker]

The same song. I think people will never have FULL access to health care, because such thing doesn't exist!! It's about distribution - you can have all people treated by moderate health care, or people treated on excellent level, but then naturally, some parts of society will be excluded...
Lorne