How the Health Care System Makes Americans Sicker

Citing high costs, some are putting off getting checked out, which puts their health — and the entire industry — at further risk in the long run.

National Journal
Marina Koren
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Marina Koren
Dec. 9, 2013, 11:52 a.m.

“Don’t wait un­til it’s too late.” That’s the motto of pre­vent­ive medi­cine that, for one-third of Amer­ic­ans, is not an op­tion.

In the last year, 30 per­cent of Amer­ic­an adults say that they or a fam­ily mem­ber put off med­ic­al treat­ment be­cause of the cost, ac­cord­ing to a Gal­lup Poll out Monday. Nearly 60 per­cent of un­in­sured people delayed get­ting checked out, more than double the amount of people with private health in­sur­ance (25 per­cent) and those with Medi­care or Medi­caid (22 per­cent).

Such pro­cras­tin­a­tion is not new. Sim­il­ar num­bers of Amer­ic­ans have been put­ting off call­ing the doc­tor to avoid ex­pens­ive treat­ment or out-of-pock­et costs since 2005. But the con­tinu­ing trend has ser­i­ous im­plic­a­tions.

In the last dec­ade, polls have shown that Amer­ic­ans are more likely to delay seek­ing med­ic­al treat­ment for a ser­i­ous con­di­tion than for one that’s not, and they’ve done so more each year. Treat­ing dia­betes costs more than treat­ing a nasty scrape or bruise.

But scrapes and bruises are not long-term threats to Amer­ic­ans’ health and the coun­try’s health care sys­tem. When med­ic­al is­sues go un­treated, they can get worse, cost­ing both pa­tients and the en­tire in­dustry much more when people fi­nally seek med­ic­al at­ten­tion. A con­cern that could have been ad­dressed by a primary-care phys­i­cian gradu­ates to a worse prob­lem treated by a usu­ally more ex­pens­ive spe­cial­ist. Even­tu­ally, it can be­come a lifelong con­di­tion cost­ing thou­sands a year in pre­scrip­tions and premi­ums.

For Amer­ic­ans, however, the threat of chron­ic ill­ness is no longer the biggest prob­lem in health care. Cost re­placed ac­cess as the top con­cern last month, then fol­lowed by obesity and can­cer.

Delay­ing treat­ment for fear of high costs could, if the Af­ford­able Care Act works as in­ten­ded, be remedied for some Amer­ic­ans. Then again, a surge in Amer­ic­ans seek­ing med­ic­al treat­ment could strain the health care sys­tem, lead­ing to longer wait times for ap­point­ments and less face time with doc­tors.

In this poll, Gal­lup sur­veyed by tele­phone 1,039 adults, aged 18 and older, liv­ing in all 50 states and the Dis­trict of Columbia, between Nov. 7 and Nov. 10. The mar­gin of er­ror is plus or minus 4 per­cent­age points.

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