The Economy and Your Health
Can You Afford to Be Healthy?
By Mary Kearl
Politicians from both the right and left are using the cost of insurance as their rallying cry and it is almost impossible to get your daily news fix without hearing about the worsening economy. Continue reading below to discover what toll the economy could be taking on the cost and quality of your health care and how preventive care could save you money and your life.
The Economy and Your Health
By Mary Kearl
While you may not be among the approximately 15 percent of uninsured Americans, the economy could still be impacting your health-care coverage and overall wellness. In 2007, nearly two-thirds of U.S. adults, or an estimated 116 million people, had difficulty paying medical bills, went without needed care because of cost, were uninsured for a time, or were underinsured -- inadequately protected from high medical expenses, according to an August 2008 report from Commonwealth Fund Biennial Health Insurance Survey.
Higher Percentage of People Skimping on Medications
Among adults with chronic health problems, more than 60 percent who were uninsured any time during 2007 and 46 percent who were underinsured reported cutting back on medications because of cost, compared with 15 percent among those with more comprehensive health insurance coverage, reports Commonwealth Fund. The 2008 study of health care in Ohio and Florida reported that about one-fourth of those surveyed never had prescriptions filled and one-fifth cut pills in half or skipped doses of medicine.
79 Million Americans Struggle to Pay Medical Bills
In 2007, 72 million people, or 41 percent of working-age adults, reported having medical debt or problems paying medicals bills, up from 58 million in 2005, according to the Commonwealth Fund report "Losing Ground: How the Loss of Adequate Health Insurance is Burdening Working Families." An additional 7 million adults ages 65 and up also reported financial problems. Families with low and moderate incomes were affected the most with more than half of adults with incomes under $40,000 reporting problems with medical bills in 2007.
Nearly 71 Million Americans Are Uninsured or Underinsured
The number of underinsured adults, or people whose health insurance does not adequately cover their medical expenses, climbed to 25 million people in 2007, up from 16 million in 2003, according to Commonwealth Fund. The silver lining: the U.S. Census Bureau reports that number of uninsured dropped from 47 million in 2006 to 45.7 million in 2007.
Fewer People Seeking Medical Treatment
The costs of health care is preventing an increasing number of people from getting needed care -- the percentage of people affected by prohibitive costs increased from 29 percent in 2001 to 45 percent in 2007, according to the Commonwealth Fund survey. This increased across all income groups and among both insured and uninsured adults. A 2008 study of health care in Ohio and Florida found that about 40 percent of adults from both states postponed getting needed dental care and between 25 and 28 percent, respectively, skipped a recommended medical test or treatment.
A Healthy Diet Is Becoming Unaffordable
A low-income family would have to allocate 43 to 70 percent of its food budget to buying the five-to-nine servings of fruits and vegetables per day, as recommended by the 2005 Dietary Guidelines, according to a November 2007 from the American Dietetic Association. The study reports that less than 10 percent of Americans meet the 2005 Dietary Guidelines. While higher-income consumers are more likely to meet dietary recommendations and low-income consumers report that produce prices are a barrier to consumption, American households across all incomes devote about 15 to 18 percent of their food budget to fruits and vegetables they eat at home, according to the study.
Income Is Linked to Obesity and Other Illnesses
A recent U.S. Department of Health and Human Services study found that women in poverty were roughly 50 percent more likely to be obese than those with higher socioeconomic status. Lower income levels have also been associated with risk of heart disease, diabetes, HIV and other sexually transmitted diseases.
Medical-Related Debt on the Rise
Forty-nine million people, or 28 percent of the population, said they were paying off medical debt in 2007, up from 2005, according to the Commonwealth Fund survey. Of those, one-fourth had $4,000 or more in debt. The 2008 study of health care in Ohio and Florida found that 14 percent of Ohioans and 17 percent of Floridians used all or most of their savings in the past year to pay medical bills. Of those who experienced medical-related financial problems in the Commonwealth Fund survey, 29 percent were unable to pay for basic necessities like food, heat or rent because of their bills.
Increase in Debt-Related Stress
A recent AP/AOL survey, Debt Stress in the United States, found that the average level of debt-related stress American adults experience has grown significantly in the four years since a similar survey was conducted. Those with higher stress levels were more likely to experience physical and mental problems including headaches, back pain, depression, severe anxiety, ulcers and heart problems.
Your Work Could Be Affected, Too
Half of employed adults in Ohio and more than four in ten Floridians reported there was a time in the past year when they were sick but went to work, specifically because they were concerned about the financial consequences of taking off work, according to the July 2008 joint report from NPR, the Kaiser Family Foundation and the Harvard School of Public Health. And in turn, work-related stress can impact your health. "Chronic stress increases heart rate and blood pressure and makes the heart work harder and that's not good for your health," says Ronald M. Davis, MD, immediate past president of the American Medical Association.
The Cost of Being Under or Uninsured
"As our nation continues to face a crisis of about 46 million uninsured, many Americans need to look no further than their own families and friends, or neighbors to find someone without health insurance," said Nancy Nielsen, M.D., and American Medical Association (AMA) President, in a statement, adding that, "Uninsured patients often don’t get the preventive care they need leading to more difficult and more costly conditions to treat."
Lack of health insurance causes an estimated 18,000 unnecessary deaths annually in the United States, according to a 2004 report from the Institute of Medicine.
When medical costs become prohibitive, people with a health problem aren't going to get the kind of treatment they need for symptoms or diseases they may have, which could exacerbate their condition, says Ronald M. Davis, MD, and immediate past president of the AMA, who specializes in preventive medicine.
Chronic illness, like high blood pressure or asthma, are manageable when give the proper medical treatment, but that isn't always an option given the costs. Among adults with chronic health problems surveyed by the Commonwealth Fund, more than 60 percent who were uninsured any time during 2007 and 46 percent who were underinsured reported cutting back on medications because of the expense.
"Not taking medications that are prescribed can result in the disease getting out of control or in having to go to the emergency room or being hospitalized, when proper adherence to prescriptions would have avoided all that," says Dr. Davis.
Asthma attacks that go untreated could result in hospitalization and even death. In the case of blood pressure, when suffers don't take their medications, they could have a heart attack or a stroke, both of which can be fatal or require long-term rehabilitation, Dr. Davis explains. Strokes can lead to brain damage, paralysis and speech impediments.
Can't Afford Preventive Care?
When money is tight, "people also tend to put off the preventive care they need, which would include screening for different kinds of cancer or heart disease; using mammograms, pap tests or colonoscopy tests -- that might also include not getting the vaccines that are recommended, including childhood vaccines and vaccines for adults such as the flu vaccine, hepatitis, tetanus and diphtheria," says Dr. Davis. For children, potentially-fatal diseases like polio, measles and whooping cough have been virtually eliminated thanks to vaccines.
While not all preventive care can save money, every $1 spent on immunization, means $10 saved in treatment costs, according to Dr. Davis.
Preventive Care Saves Lives
"There is significant underuse of effective preventive care in the United States, resulting in lost lives, unnecessary poor health, and inefficient use of health care dollars," according to the 2007 "Preventive Care" report from Partnership for Preventions, a coalition of organizations that favor policies and practices to prevent disease and improve the health of all Americans.
The report found the following preventive cares to be cost-effective and life-saving:
-If 90 percent of adults started taking daily aspirin to prevent heart disease, it could save 45,000 annually. Currently, fewer than half of American adults take aspirin preventively.
- If 90 percent of smokers were advised by a medical professional to quit and received medications or other assistance it could save 42,000 lives each year. Today, only 28 percent of smokers receive such services.
-If 90 percent of adults over the age of 50 stayed up to date with recommended colorectal screenings it could save up to 14,000 lives annually. Today, fewer than 50 percent of adults are up to date with screenings.
-If 90 percent of adults over the age of 50 received annual flu immunizations it could save 12,000 additional lives. Today, 37 percent of adults have had an annual flu vaccination.
-12,000 additional lives would be saved each year if we increased to 90 percent the portion of adults age 50 and older immunized against flu annually. Today, 37 percent of adults have had an annual flu vaccination.
Read the report here.
What Preventive Measures Should You Take?
The U.S. Preventive Services Task Force is a federal committee that makes recommendations on preventive services ranging from screenings, checkups, counseling, immunization and medications. Recommendations vary by age. Visit the site for more details.
