The High Cost Of Care


It’s supposed to be the Affordable Care Act, right? So why are consumers finding that health care has become anything but affordable?

The New York Times teamed with CBS News to gather the experiences of 10,000 Americans who are struggling to pay for health care. What they found in their study, “Paying Till It Hurts,” seems to make the case that the Affordable Care Act is actually unaffordable for many.

Nearly half of those polled (46 percent) said that paying for health care is a hardship for them and their family. This is an increase of 10 percentage points over the same time last year.

Even those who have good insurance coverage are unhappy with rising out-of-pocket costs. More than half of those polled said the amount of money they and their family have paid out of pocket for health care and prescription drugs has gone up over the past few years, and about a third said those costs have increased significantly.

The main reason for these increases is that newer insurance plans under ACA are doing away with fixed co-pays – for example, $25 for an office visit – and replacing them with requirements that patients pay a percentage of the charges. Although part of the reasoning behind this is that consumers will be more mindful of their use of health care, the reality is that patients wind up paying far more out of pocket.

The good news about the ACA is that insurance plans are required to cover a variety of screening tests, such as colonoscopies. The bad news is that any treatment that results from those screening tests means patients will have to shell out money. Nearly one-third of the respondents to Times poll said they are forgoing treatment, if they have insurance, because they cannot afford the deductible or are worried about potential costs.

Another concern that surfaced in the poll is that Americans wish their doctors could be upfront about the costs of care. How much does that office visit really cost? What about those X-rays or setting that broken bone? Physicians say they often don’t have the answers and consumers would like to avoid a nasty surprise when the bill comes due.

Thirty-seven percent say they or one of their immediate family members have had trouble keeping up with their medical bills in the last few years. Those with lower incomes are more likely to have had trouble paying their medical bills.

In addition, 28 percent of Americans say they been contacted by a collection agency because of medical bills. And among those who have had trouble paying their medical bills, nearly two-thirds have been contacted by a collection agency.

Nearly half said they have received a medical bill that was bigger than they had anticipated. About a quarter said they never go to a doctor and, of that group, 78 percent said the main reason they don’t see a doctor is because of cost.

So if people are paying more for health care and they are afraid to access the system as a result, is the Affordable Care Act really making care affordable?



Susan Rupe is assistant editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Connect with Susan →

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