Thursday, Sept. 23, 2004 | 11:22 a.m.
Even with insurance, an increasing percentage of working-age Americans with chronic medical conditions are struggling to pay their medical bills, a national study reported today.
The Center for Studying Health System Change, a nonpartisan research organization, released a study today that found that 19 percent of people with chronic medical conditions spent more than 5 percent of their family income on medical bills in 2003, excluding their monthly insurance premiums. That's up from 12 percent in 2001.
The situation is even more serious for people with low incomes. The percent of chronically ill private-insured people, with family incomes of $36,800 or less, who spent more than 5 percent of their family income on medical bills rose to 42 percent in 2003 from 28 percent in 2001, the study found.
"Rising health care costs and the increase in cost-sharing has really begun to take a toll on low-income, privately insured people," said Ha Tu, author of the study and a researcher with the Washington-based center. "Health care costs continue to rise much faster than incomes. A growing proportion of Americans are finding the health care system unaffordable even when they have insurance."
Las Vegas Valley physicians and patient advocates say the study is not surprising and that rising health costs are hurting low- and middle-income people in Nevada.
Higher premiums mean fewer people can afford insurance, which increases their out-of-pocket costs on medical bills and reduces the number of people who can afford treatment, said Dr. Michael Colletti, a rheumatologist and president of the Clark County Medical Society.
"There are a lot of middle-income people who can no longer afford health insurance," he said. "These premiums are getting increasingly expensive and they go up year after year."
"More and more employers are going to either not offer health insurance or they're going to start asking the employees to pay more of the cost," Colletti said. "People are going to have less medical care."
The Kaiser Family Foundation reported earlier this month that premiums rose an average of 11.2 percent from the spring of 2003 to the spring of 2004, marking the fourth consecutive double-digit increase.
Colletti said part of the reason medical costs have increased so dramatically is because of the threat of litigation.
"What these lawsuits have created is defensive medicine, which is unnecessary things doctors are forced to do to protect themselves from getting sued," Colletti said. "Technology is driving up the cost of medicine, but people want the latest and the best treatments for their illnesses."
K.B. Forbes, executive director of the patient advocacy group Consejo de Latinos Unidos, blamed rising health care costs on "outrageously high hospital pricing."
"It is the cause of why 46 percent of bankruptcies are caused by medical debt," he said. "We're not talking about a doctor's visit for a runny nose. We're talking about a hospital bill for treating complications of a chronic condition or an emergency."
Hospitals charge significantly more than their actual costs, he said.
A study released earlier this month by the Institute for Health and Socio-Economic Policy on behalf of the California Nurses Association reported that Nevada hospitals' charges were as much as 525 percent higher than their actual costs in from iscal year 2002 to fiscal year 2003.
"Why have premiums gone up?" he asked. "Insurance companies are to blame because they're not fighting these hospitals. They pass those costs onto the policyholders."
The study of 46,600 people found that about half of the respondents with chronic conditions said they were likely to delay their medical care because of the costs. Chronic conditions included in the study were abnormal uterine bleeding, asthma, arthritis, benign prostate enlargement, cancer, chronic obstructive pulmonary disease, diabetes, depression, heart disease and hypertension.
If patients with chronic conditions do not get preventive treatment and ongoing care, they can encounter serious health complications, the study said.
Tu said the Center for Studying Health System Change does not endorse policy recommendations, but has seen other studies that show that lower costs up front can save employers money in the long run.
"Studies have shown that when drug co-payments are increased from $10 to $20, which is a common increase for employers, they found that people with chronic conditions have curtailed their use of prescribed drugs," she said. "Making those drugs cheaper for those employees who need them has resulted in fewer visits to the emergency room and fewer hospitals stays."
In addition to lower co-payments, the study indicated that cost-sharing could be varied based on income. Some employers tie premium contributions to income and the study says other studies show that this approach could be expanded to deductibles and out-of-pocket maximums.
archive
