Economic Pressures Leading Many to Make Medical Sacrifices


"We need to do better, but more physicians are doing something to help patients," said Dr. Roland Goertz, board chair of the American Academy of Family Physicians (AAFP). Goertz referenced a 2009 AAFP survey that found 66 percent of doctors took some action to help financially-strapped patients, such as offering lower-cost office visits, providing free screening and prescribing more generic drugs.

"Many patients are resistant to talking about their financial situation," said Goertz. "I always ask if they have enough money for the co-payment."

Patients should also be more proactive when it comes to their prescriptions.

"Make sure you ask about lower-cost alternatives," said Fendrick. "Many drug manufacturers have programs for people who are economically challenged."

"Communities also often have programs to help with medical costs. Doctors' offices may have rosters of agencies that can help, so ask about it," said Goertz.

"If you have to follow-up after a treatment and you don't have insurance coverage, it makes sense to ask if you can check in by phone or by email," said Robert Field, professor of health management and policy at the Drexel University School of Public Health.

Pharmacists are also a valuable source of important information. They can help in various ways, such as by looking up drug prices, finding out if generics are available and checking for drug interactions.

In addition, every chain pharmacy and big-box store pharmacy has a $4 generic drug program, Gill said, so consumers should seek those out.

"Even with insurance, the cost of a generic drug may be more expensive than these $4 programs," she added.

Experts stress that trying to split pills, skip doses or take expired drugs can often render the medicine completely ineffective, which can be dangerous.

A More Affordable Future?

Some experts say the health care system is slowly moving in a more affordable direction.

Fendrick believes there will be a shift toward a value-based insurance design that will make the most important health services cheaper depending on a person's condition while making ineffective or harmful treatments much more expensive. Under the current system, the patient's out-of-pocket cost is the same regardless of how vital or unimportant a particular service is.

"This design provides the nudge to allow easy access to services people absolutely need and if it's necessary, makes it really hard to do something that's inefficient," said Fendrick.

Goertz explained there is also a shift toward a more comprehensive system of patient care that helps clinicians coordinate better. With this model of care, a patient's primary physician can manage care across specialties and can also incorporate information about insurance coverage and the situation at home, making it easier to get a sense of a patient's financial burden.

But until the health care system drastically changes in a way that makes getting medical care much more affordable, Kintz, who lives with damaged lungs and can't afford all her medication, advises people in situations like hers to reach out for help.

"There is help out there," she said. "You can call organizations like the American Cancer Society and get phone numbers and help for little things like gas. Joining a support group is also helpful. Just let people know you need help."

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