Medical Debt Affects Some 20 Million Americans, Study Finds
One in seven U.S. families, or about 20 million total, had problems paying medical bills last year, and many of them had to choose among paying health care, food and housing expenses, according to a new report to be released Wednesday by the Center for Studying Health System Change, the Wall Street Journal reports. The results come from the 2003 Community Tracking Study Household Survey of some 25,400 families, or about 46,600 individuals (Kissel, Wall Street Journal, 6/30). About 63% of families who said they had problems with medical bills problems also reported having difficulty making payments for rent, mortgages, transportation or food. More than 60% of families with medical bill problems also said they were contacted by collection agencies, and about 50% reported that they delayed a major purchase or borrowed money because of medical bill problems. People in families with medical bill problems were four times more likely than those without such problems to report delaying care in the past year because of cost concerns and five times more likely to report an unmet medical need because of high costs (HSC release, 6/30). According to the report, 43 million individuals in the 20 million families thought to have medical bill problems had to adjust their health care needs because of cost concerns. Thirty percent of those did not fill a prescription and about 25% delayed care because of cost concerns, according to the survey (Yu, Dallas Morning News, 6/29).
About 20% of low-income families earning less than 200% of the poverty level reported difficulties paying medical bills, compared with 7.4% of families with incomes greater than 400% of the poverty level, according to the survey (HSC release, 6/30). In addition, families in which the survey respondent was age 65 or older and covered by Medicare were least likely to report medical bill problems (7.1%). By comparison, 11.1% of nonelderly families with private health insurance and 17.2% of nonelderly families with public health insurance reported having problems paying medical bills. Twenty-four percent of uninsured families reported having problems paying medical bills, compared with 11.4% of insured families. Insured families still comprise 68% of those with medical bill problems, according to the survey (HSC release, 6/30). About 18% of families with one or more members with chronic diseases reported having medical bill problems (Wall Street Journal, 6/30).
Paul Ginsburg, president of HSC, said, "Medical debt is a problem for one out of seven American families and often reaches a serious enough level to negatively affect family finances and access to care." Peter Cunningham, one of the report's authors, added, "For families with existing medical bills -- especially lower income families -- the fear of generating additional medical bills and some providers' unwillingness to treat patients with outstanding debts may force many to postpone or forego needed medical care because of out-of-pocket costs" (HSC release, 6/30). Michele Heisler, a researcher at the Veterans Affairs Ann Arbor Healthcare System, said, "There are a lot of effective medications out there, which makes the problem of access to medicines a concern." Bob Crittenden, chair of the Working for Health Coalition in Seattle, said, "Being uninsured or having low income is terrible, but being insured isn't a guarantee of success" (Wall Street Journal, 6/30). The study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.