Our Views: Rise of debt for patients
Print
Email
Save
Share
Del.icio.us
Digg
Facebook
Reddit
As the candidates talk about health care in this election year, much of the commentary will be on the uninsured — the millions of Americans who have no access to health insurance and therefore suffer from limited health care, or face debilitating debts when they do fall sick.
Yet the issue isn’t a problem of “insured” and “noninsured.” Even those with insurance are seeing an erosion of coverage that is causing pain in many households.
One in five Americans has medical debt, according to a new study, and nearly two-thirds of people who reported being in debt or having problems with medical bills had health insurance when the bill was incurred.
Writing in The American Prospect, analyst Tamara Draut noted that the trends are disturbing and should factor into the debate about health care.
It is not that the uninsured are without problems: Half of uninsured adults in the Commonwealth Fund study reported medical debt or bill problems. “The reality is uninsured patients may actually be charged more for care they get at the doctor’s office,” Draut said. “Insured patients get negotiated discount rates, while those without insurance are charged and often expected to pay the full sticker price.”
Hospitals and doctors are turning to credit-card companies or other means of providing credit to patients when they receive care. The so-called “self-pay” market is not only the uninsured but those with high-deductible health insurance, or insurance that does not pay for various procedures or treatments.
Up-front costs are one thing, but fear of medical debt causes people with health insurance to delay or forgo health care they might otherwise get. “In other words, it’s causing the insured to act like the uninsured,” Draut said.
A Kaiser Family Foundation study found that patients with medical debt and insurance were more than four times as likely as their debt-free counterparts to delay care, more than twice as likely to leave needed prescriptions unfilled and more than three times as likely to skip recommended treatments and tests.
At its core, Draut observes, health insurance is intended to shield — by spreading around risk and premiums — families from financial devastation caused by health problems.
When candidates talk about health care this year, we hope that they look at all sides of this issue.
