Views on Health Care Costs
When asked to name the most important health problem for the government to address, health care costs historically top the list. In August 2005, such costs were mentioned by nearly four in ten adults (39%).
Many adults report experiencing rising health care costs. Two-thirds (66%) of those with health insurance say their premiums have increased over the past five years, including 38% who say premiums have gone up “a lot”. Around half of insured adults say their co-payments for provider visits (51%) and health insurance deductibles (49%) have risen in the same period. The public believes rising health care costs to be caused by numerous factors, with high profits made by drug and insurance companies as the most commonly cited (35% of adults say this is the most important factor).
Problems with Medical Bills
Medical bills pose a significant challenge for many. Nearly one-quarter (23%) of adults report problems paying medical bills within the past year, and more than six in ten of these (61%) have health insurance. One in five adults (21%) reports currently having an overdue medical bill, and almost as many (19%) report experiencing serious financial consequences in the past five years due to medical bills. A similar share (18%) say health care costs are their biggest monthly expense excluding rent or mortgage payments.
Health Care Costs Create a Barrier
Health care costs create significant obstacles to obtaining health care for many people. Nearly three in ten adults (28%) report a time in the past year when they did not have enough money to pay for medical or health care.
A substantial minority of adults report delaying or skipping needed health care because of cost. Nearly three in ten adults (29%) say that they or a family member has avoided filling a prescription, has skipped recommended medical tests or treatment, or has cut pills or skipped doses of medicine because of cost. A majority of these (56%) assert that their condition worsened as a result.
Vulnerable Populations: Those with Chronic Health Conditions
More than four in ten adults (44%) report having a chronic health condition such as heart disease, cancer, asthma, arthritis, or diabetes, or a handicap that limits their daily lives. This group has a significantly harder time accessing health care specifically because of costs. For example, nearly four in ten of those with chronic conditions (38%) report they or someone in their household has skipped medical treatment, cut pills, or didn’t fill a prescription because of the cost, compared to about two in ten (22%) healthier adults.
Vulnerable Populations: The Uninsured
Among the uninsured, cost is the most often cited reason for lacking coverage. Seven in ten (70%) uninsured adults say that cost is the main reason they are uninsured. Just six percent say they don’t have insurance because they don’t need it. The uninsured report considerably more problems accessing health care because of costs than the insured. Uninsured adults are twice as likely to report that they or a member of their household skipped medical treatment, cut pills, or did not fill a prescription in the past year because of the cost (51% uninsured vs. 25% insured).
Consumer Strategies to Lower Costs
Despite their views, worries, and experiences with health care costs, consumers report having few cost-containment strategies at their disposal. Few respondents (11%) report trying to negotiate prices with their health care providers, though more uninsured than the insured say they have done this (24% vs. 8%). Nineteen percent of adults report having a doctor resubmit a rejected insurance claim, 9% have used the Internet to find lower prices on prescription drugs, and 7% have switched doctors to reduce out-of-pocket expenses.
Discussion of cost between medical providers and consumers is inconsistent. About a third (35%) of adults say their doctor has never explained the costs associated with a recommended procedure, and another 17% say this has rarely happened. Twenty-five percent of adults, in contrast, say their doctor “almost always” explains costs of recommended procedures.
