Americans borrowed an estimated $88 billion to pay for health care last year and one in four people skipped care because of costs, according to a new Gallup survey funded by a nonpartisan health group.
The nationwide survey of 3,537 adults also found that lower-income adults were more likely to skip care or fear bankruptcy over spiraling medical costs. But even affluent households have deferred care over concerns about finances.
West Health, a group of nonprofits funded by Gary and Mary West, commissioned and funded the Gallup survey to ask Americans how health costs affect their own finances, choices about care and views on the health-care system, according to Tim Lash, West Health’s chief strategy officer.
Lash says that worries about financial hardship from medical bills cut across all income levels.
“Lower income brackets had the most fear,” Lash says. But “that fear persisted even for those we would associate with the middle class and upper middle class. It’s not just those living at or slightly above poverty that are concerned. It’s even the more affluent among us.”
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The telephone survey was conducted Jan. 14 to Feb. 20 among insured and uninsured adults in 50 states and Washington D.C. The margin of error ranged from 1.2 percent to 2.1 percent.
About one in eight people said they borrowed to pay health costs for themselves or a family member, says Dan Witters, a Gallup senior researcher.
Based on more detailed questions among people who used credit or other forms of borrowing, Gallup estimated 2.7 million Americans borrowed at least $10,000 and another 1.6 million borrowed more than $5,000.
Gallup estimated that Americans collectively borrowed $88 billion to pay for health care over the past 12 months.
If that estimate is correct, it means Americans borrowed 2.5 percent of the nation’s total $3.5 trillion in health spending in 2018.
Benedic Ippolito, an American Enterprise Institute research fellow and health economist, says Americans often think medical debt is different than other types of debt.
Ippolito’s research released last year found than one in six Americans have a past-due medical bill on their credit report. Most than half of those bills were for less than $600, and young adults were more likely to have an unpaid medical bill than older adults even though older adults typically spend more on health care.
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“It’s just so low priority relative to paying the mortgage, the car, they simply don’t pay it,” Ippolito says. “Not because they couldn’t but because it is not as important.”
The Gallup survey revealed that people often don’t know what they will pay for care at a hospital or for an outpatient surgery. About one in three adults reported that doctors discussed cost before ordering a recommended drug or procedure.
In addition to questions about personal finances, the Gallup poll asked people how they view the American health-care system’s quality and whether Congress can effectively rein in medical prices.
Survey respondents who identified as Republican were more likely than Democrats to believe that U.S. health quality was the best or among the best in the world.
But two-thirds of Republicans and Democrats are “not at all confident” that Congress can achieve a bipartisan solution to lowering health costs.
Lash says that informing the public about health costs also must include a discussion on quality.
“Too many Americans justify the high cost we’re spending with this false belief that it’s justified because of the outcomes we’re getting,” Lash says. “Perhaps displacing that myth, we’ll get more engagement and a little more commitment to advancing smart policies.”