Medical Debts Put Patients at Risk of Financial Collapse

The crisis of American health care is not limited to uninsured people, unable to pay for their care. This article shows a deepening problem of working people with insurance unable to pay for treatment of serious illnesses.

By Lindy Washburn – The Bergen Record
First Posted: January 27, 2012

HACKENSACK, N.J. — Frances Giordano found out she had lung cancer in June. After that, the bad news just kept coming.
First, she discovered that even with a good job and health insurance, her medical expenses were more than she could afford on disability.

Then she started slipping into debt, like millions of other Americans who don’t have the cash to cover their medical bills. Hospitals expect to be paid promptly and offer little leeway to insured patients. Unpaid bills go to collection agencies, damaging a person’s credit history for years.

Finally, she learned that fighting for her life was not her only battle or maybe even her toughest. When she finished her chemotherapy in December, she was fired. “Due to changes in business operations,” wrote her employer of more than six years, “We can no longer hold your position open.”

It arrived nine days before Christmas.

“I’m a good person,” the 58-year-old Giordano said in an interview, crying. “I worked hard. Isn’t having cancer enough?”
The crisis in American health care is not limited to hospital emergency rooms where uninsured people wait for care. It also is found in a neat, three-bedroom house in Dumont, N.J., occupied by a widow who worked full time, raised two kids and likes to get her nails done occasionally.

In less than a year, Giordano lost her health and her job. Now, she’s afraid she’ll lose her good credit and her health coverage.

In the lonely hours of the night, she said she thinks about giving up.

Giordano had health insurance throughout her illness. She didn’t have to beg for treatment and was not denied it. She loves the surgeon and oncologist and nurses whose care, she hopes, will give her many more good days with her first grandchild, born in July.

But she may be ruined financially. In this country, people can go broke if they get sick.

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Recession leads many patients to skip routine care

American Medical News

Another study reveals more Americans are sacrificing needed care due to the troubled economic times.

A North Carolina survey also finds 36% of respondents report buying fewer prescription drugs.

Economic worries appear to be keeping patients in North Carolina from seeking regular physical exams and routine dental visits. Medical tests and operations are being delayed. More time is lapsing between prescription refills, if they are filled at all.

This is true even for some patients who have insurance, according to the results of a survey by BlueCross BlueShield of North Carolina released Oct. 19.

“The recession and rising health care costs are having an impact on preventive health services. … But there’s never a good time to skip preventive health and healthy living,” said Don Bradley, MD, the North Carolina Blues’ senior vice president and chief medical officer.

To gauge the effect of the economy in North Carolina, the insurer commissioned the Durham, N.C.-based market research firm W5 to conduct a survey in April and May, talking to 501 people in the state, including those who were uninsured or covered by other insurers.

Approximately 17% reported skipping a regular physical exam because of cost, and 17% were decreasing their visits to specialists. In addition, 17% were postponing tests or operations and 15% were refusing these procedures outright.

The economic downturn also affected patient willingness to fill prescriptions. About 36% bought fewer prescription drugs, and 31% refilled them less frequently. Fifteen percent were not filling prescriptions given to them, and 21% said they relied more on over-the-counter medications.

These percentages were much higher for those who were uninsured, although a significant proportion of those with insurance were also taking belt-tightening steps.

National surveys have found similar results, suggesting the economic downturn is taking its toll on patients’ ability to access health and the financial viability of medical practices.

An American Academy of Family Physicians survey released in May found 89% of its members were seeing more patients who were expressing concerns about their ability to pay for health care, and 58% of physicians were seeing an uptick in appointment cancellations. The survey is online (www.aafp.org/online/en/home/media/releases/newsreleases-statements-2009/nationalsurvey-familydoctors-recession.html).

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