The high cost of health care is placing a heavy burden on more than 137 million Americans in the form of stress or delayed care, according to a new study by American Cancer Society (ACS). Additionally, researchers found that medical financial hardship is on the upswing in the U.S.

The consequences of high out-of-pocket spending for medical needs may include a depletion of assets and pressure on household finances. Patients may delay or forgo needed medical care because of cost, jeopardizing benefits of treatment.

If an illness affects the ability to work or reduces productivity at work, access to employer-sponsored health insurance may be affected and household income decreased.

Previous studies have looked at the financial toll of a cancer diagnosis, but this is the first to explore health care-related financial hardship in the general population, Researchers led by Robin Yabroff, Ph.D., assessed how the inability to pay medical bills and worry about finances affected Americans, using data from the 2015-2017 National Health Interview Survey.

What they found:

  • 56.0 % of adults reported at least one area of medical financial hardship, representing 137.1 million adults in the United States
  • Compared with those 65 years and older, adults 18 to 64 reported higher material (28.9% vs. 15.3%), psychological (46.9% vs. 28.4%) and behavioral (21.2% vs. 12.7%) medical financial hardship.
  • Among adults 18 to 64, those with less educational attainment and more health conditions were more likely to report great intensity of hardship.
  • Women were more likely to report multiple types of hardship than men.
  • People who were uninsured were more likely to report multiple domains of hardship (52.8%), compared to those with some public (26.5%) and private insurance (23.2%).

Unless health care costs are brought under control, the authors warn, the problem is likely to worsen.

“With increasing prevalence of multiple chronic conditions; higher patient cost-sharing; and higher costs of healthcare; the risk of hardship will likely increase in the future. Thus, development and evaluation of the comparative effectiveness and cost-effectiveness of strategies to minimize medical financial hardship will be important.”

The study appeared online in the Journal of General Internal Medicine.

Article: Prevalence and Correlates of Medical Financial Hardship in the United States; Journal of General Internal Medicine 2019 DOI