From yesterday’s NYT:
Maybe I’ll Get Better on My Own
While politicians have been debating endlessly over the best ways to reform the American health care system, the plight of American patients has rapidly worsened. A new national survey found that an alarming 20 percent of the population, some 59 million people in all, either delayed or did without needed medical care last year, a huge increase from the 36 million people who delayed or did not seek care in 2003.
As expected, people who have no health insurance — there are some 47 million of them — were most likely to make that difficult choice. But insured people also chose to go without care in ever-larger numbers.
According to the survey, the main reason is soaring medical costs, which have outstripped the modest growth in wages in recent years. High costs are deterring not only the uninsured from seeking care, but also many insured people who are struggling with higher deductibles, co-payments and other out-of-pocket expenses as their employers or health plans shift more of the cost burden to them.
Many patients with insurance said they went without care because their health plans would not pay for the treatment or their doctors or hospitals would not accept their insurance. Both insured and uninsured patients said they skipped treatments because they had trouble getting timely appointments, were unable to get through on the telephone, or could not make it to a doctor’s office or clinic when it was open. No doubt a weakening economy, high fuel prices, the home foreclosure crisis and general economic anxiety also played a role.
Sadly, previous gains in caring for low-income children have reversed, largely because their parents lost employer-sponsored coverage.
The telephone survey of some 18,000 Americans was conducted by the Center for the Study of Health System Change, a respected nonpartisan research group, and was financed by the Robert Wood Johnson Foundation. It relied on respondents’ views that they needed the care and did not explore what health consequences resulted.
Champions of so-called “consumer-directed health care” might argue that the market is working — people are wisely delaying or forgoing care of low marginal value. But it is disturbing that unmet medical needs increased the most for people in poor or only fair health — those most likely to get even sicker if they don’t get treatment.
The new survey further strengthens the case for universal coverage, with moderate cost-sharing provisions. All Americans should be able to get medical care when they need it.