Healthcare or Food?

Megan Swanson has anxiously watched her family’s savings dwindle as inflation eats away at a reserve for emergencies. Ms. Swanson, 37, is a part-time student who hadn’t worked since she was laid off during the beginning of the pandemic when the local Nordstrom store closed in 2020. Her husband, Brett, 37, is the wellness director at a retirement community.

Last March, the Swansons found themselves struggling to cover medical bills. Their infant daughter was hospitalized following a febrile seizure. They ended up paying the remaining $8,000 that wasn’t covered by insurance.

Febrile seizures occur in children between 6 months and five years old. Children typically have a fever of more than 38°C (100.4°F). These seizures do not have an additional cause, such as head trauma or epilepsy.

The Swansons are not alone. According To The Kaiser Family Foundation, a quarter of those who owe money for medical bills owe more than $5,000. And nearly one-fifth of those with any debt indicated they never expect to pay it off.

Rising healthcare costs lead many families like the Swansons to delay medical care. Megan frequently postpones her medical appointments, including yearly appointments with a dermatologist to screen her for skin problems caused by prolonged exposure to the Florida sun.

“We are starting to see some individuals who are putting off some care, especially preventive care, due to the costs,” said Dr. Tochi Iroku-Malize, the president of the American Academy of Family Physicians and the chair of family medicine for Northwell Health in New York. Choosing between going to the doctor or paying for rent and food, “the health issue is no longer the priority,” she said.

About four out of ten Americans indicated they would postpone care in 2022 due to cost, the largest number since Gallup began asking about postponing care more than 20 years ago. The number of people who said they or a family member delayed getting health care because of cost increased from 26 percent in 2021 to 38 percent in 2022.

According to a recent Commonwealth Fund report, 29 percent of people with employer-based coverage were underinsured due to high out-of-pocket costs, even with insurance. This percentage will only increase in the coming months due to the end of the COVID-19 public health emergency. The Biden administration predicts that 15 million people will lose Medicaid or CHIP coverage come May.

Prices of prescriptions, hospital stays, and other medical services are expected to increase even more over the next year, says Sean Duffy, the co-founder and chief executive of Omada Health, a company in San Francisco that provides virtual care and coaching to people with chronic health conditions like diabetes. The company’s employees were already starting to see more patients wrestling with how to pay for medicine and healthy food.

Unfortunately, medical debt prevents some people from getting the care they need. According to a poll by the Kaiser Family Foundation, around 14% of those with debt had been denied access to a hospital, doctor, or another provider due to outstanding charges.

Margaret Bell, 71, of Lancaster, S.C., learned that her cancer had returned four years ago. She was reluctant to begin receiving chemotherapy because of the cost. Even more troubling, she regularly skipped medical appointments with her care team.

“It is impacting patients’ access to care,” Ms. Bell’s oncologist, Dr. Kashyap B. Patel, said.

Patel is the chief executive of Carolina Blood and Cancer Care Associates in Rock Hill, S.C. He recently set up a nonprofit group called No One Left Alone. The organization assists patients with covering the cost of treatment and providing additional support, including referrals to charitable organizations. The cost of Bell’s visits is covered through No One Left Alone.

For Bell, having family over for dinner is an added financial burden. She often can’t afford the high grocery bill. Therefore, she has to decide which of her medical needs is the most urgent. Recently, she has delayed surgery to receive a pacemaker.

Pacemakers are electric activity-generating devices that are used to treat people who have a slow heart rate, symptomatic heart blockages, or heart failure. All cardiac pacemakers are made up of a pulse generator that creates the electrical current needed to stimulate the heart musculature and one or two electrodes that communicate the electrical activity created by the pulse generator to the heart musculature.

Living with a disability or chronic illness is also expensive. According to the National Disability Institute, researchers estimate that households containing an adult with a disability in the U.S require, on average, 28 percent more income (or an additional $17,690 a year for a family at the median income level) to obtain the same standard of living as a comparable household without a member with a disability.

The Ward family from Chicago, IL, faced more than $800,000 in debt after the premature birth of their twins, who were later diagnosed with Cerebral Palsy.

Many disabled people require durable medical equipment or specialized supplies. Examples include shower chairs, beds, patient lifts, wheelchairs, and incontinence products. Unfortunately, these items aren’t always covered by insurance either. Many people resort to crowdfunding to pay for medical expenses. According to the CEO of the fundraising website GoFundMe, approximately 33% of all donations go toward medical expenses.

Childbirth, chemotherapy, radiation, broken bones, and toothaches can cause Americans financial hardship. Every day, Americans make life-or-death medical decisions. For some, these decisions result in tens of thousands of dollars in debt. Nobody should be in debt because of medical treatment, but millions of Americans are. We need affordable healthcare for all Americans before this crisis worsens.

Sources:

Abelson, Reed. “Higher Bills Are Leading Americans to Delay Medical Care.” The New York Times, The New York Times Company, 16 Feb. 2023, https://www.nytimes.com/2023/02/16/health/inflation-delayed-health-care.html.

Galewitz, Phil. “As Pandemic-Era Medicaid Provisions Lapse, Millions Approach a Coverage Cliff.” Kaiser Health News, Kaiser Family Foundation, 2 Feb. 2023, https://khn.org/news/article/medicaid-unwinding-coverage-loss-states-post-pandemic/.

Goodman, Nanette, et al. “The Extra Costs of Living with a Disability in the U.S. — Resetting the Policy Table.” National Disability Institute, National Disability Institute, Oct. 2020, http://www.nationaldisabilityinstitute.org/wp-content/uploads/2020/10/extra-costs-living-with-disability-brief.pdf.

Levey, Noam. “Sick and Struggling to Pay, 100 Million People in the U.S. Live with Medical Debt.” NPR, NPR, 16 June 2022, https://www.npr.org/sections/health-shots/2022/06/16/1104679219/medical-bills-debt-investigation.

Levey, Noam, and Aneri Pattani. “Medical Debt Upended Their Lives. Here’s What It Took from Them.” NPR, NPR, 16 June 2022, https://www.npr.org/sections/health-shots/2022/06/16/1104969627/medical-debt-upended-their-lives-heres-what-it-took-from-them.

Leung, Alexander K.C et al. “Febrile seizures: an overview.” Drugs in context vol. 7 212536. 16 Jul. 2018, doi:10.7573/dic.212536

Martinez, Gina. “GoFundMe CEO: One-Third of Fundraisers Are for Medical Costs.” Time, Time Inc, 30 Jan. 2019, https://time.com/5516037/gofundme-medical-bills-one-third-ceo/.

Nelson, Glen D. “A brief history of cardiac pacing.” Texas Heart Institute journal vol. 20,1 (1993): 12-8.

Park, Alice. “What End of COVID-19 Public Health Emergency in U.S. Means.” Time, Time Inc., 31 Jan. 2023, https://time.com/6251520/covid-19-public-health-emergency-ends-what-changes/.

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