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Costs Hurt Those Who Need Healthcare Most

Costs Hurt Those Who Need Healthcare Most

Fifty-two percent put off treatment for serious condition

by Rick Blizzard

Reduced access to healthcare services is a financial hardship that threatens Americans' quality of life more directly than any other. Since January, healthcare costs have topped the list when Americans were asked to name the most important financial problem their families face.

Gallup recently conducted a special survey of almost 5,000 members of The Gallup Poll Panel*, to gauge their opinions on several healthcare issues. One result in particular jumped out at me: Just 6% reported being satisfied with the total cost of healthcare in the United States (rating it a "4" or "5" on a 5-point satisfaction scale). More than 7 in 10 (71%) were dissatisfied -- including 46% who said they were "not at all" satisfied.

These truly astounding numbers bear closer examination. Though few Americans are satisfied with healthcare costs, some groups are more concerned than others. Logically, dissatisfaction rises as household income decreases. Sixty-two percent of those in households earning $25,000 or less annually are not at all satisfied, compared with just 38% of those in households earning $75,000 or more.

Concern about the cost of healthcare is also tied to respondents' self-reported health status. Forty-three percent of those who rate their own personal health as excellent or good are not at all satisfied with the cost of healthcare, compared with 60% of those who rate their own personal health as fair or poor. That finding doesn't mean high healthcare costs contribute to poor personal health -- it could simply be that those in poor health have more healthcare costs. The important question remains: Does the high cost of healthcare services affect the behavior of those in need?

Avoidance of Medical Treatment

Thirty-two percent of panel respondents reported that in the last 12 months they have put off medical treatment because of costs they would have had to pay. The cost of services does indeed influence Americans' willingness to access services, and this influence apparently is greater among lower-income households.

Those who characterize their physical health as "fair" or "poor" are significantly more likely to have put off treatment because of cost than those who say their health is "excellent" or "good" -- 49% vs. 29%. This finding may seem self-evident, but it also points to the notion that many people may be postponing treatment for non-trivial health problems. Forty-seven percent of those who said they'd postponed treatment report that the condition for which that treatment was delayed was "somewhat serious," with another 5% saying it was "very serious."

Again, income is a significant factor in the likelihood to delay treatment for a very or somewhat serious condition. Those in households with lower annual incomes are more likely to put off treatment for more serious conditions than are those in upper-income households.

Bottom Line

Americans are highly dissatisfied with the cost of healthcare and this is affecting their behavior when it comes to getting healthcare. As importantly, income has become a serious barrier to accessing needed services. In other words, these data help confirm that the barrier to services is greatest among the populations most likely to need them.

They also confirm that improving access to healthcare isn't simply a matter of increasing the supply of physicians and physical access to services in low-income areas. In fact, increasing the presence of various services may actually increase the percentages of those who report delaying treatment because of cost, and ratchet up the anger and frustration of those for whom needed services are just out of their financial reach. There's no shortcut to the long-overdue structural changes that make healthcare costs more equitable and prevent those in need from postponing care.

*These results are based on telephone interviews with a randomly selected national sample of 4,984 adults in the Gallup Poll Panel of households, aged 18 and older, conducted Nov. 16, 2004 to Jan. 5, 2005. For results based on this sample, one can say with 95% confidence that the maximum error attributable to sampling and other random effects is ±1.5 percentage points. In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

 


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