March 2009

As Families Cut Back on Health Care, the Need for Reform Grows More Urgent

During these difficult fiscal times, everyone is looking for ways to cut back on their spending, from eating out less to putting off big expenditures. While unpleasant, that belt-tightening is usually bearable. Some services, however, remain absolutely essential to us, and chief among them is our access to health care.

That is why it was so disturbing to see the results from a recent Kaiser Health Tracking Poll: 53% of Americans say they have cut back on health care in the past year due to cost concerns. From using home remedies to solve ailments, to skipping dentist appointments and doctor check-ups, to diluting prescriptions or not filling them altogether, the majority of Americans are finding access to basic health care services unaffordable.

The study also found that roughly one in five individuals were experiencing serious financial problems due to family medical expenses that could not be postponed. These individuals reported spending all their savings and failing to pay other bills, and 7% said they were unable to afford heat, housing, or food.

And, the individuals surveyed expect these issues to worsen: 45% report they are “very” worried about having to pay more for their health care or health insurance, and one-third of those with health coverage are afraid of losing it.

These findings underscore the fact that health care has become unaffordable for millions of Americans and that the current recession will only exacerbate this problem. Some 47 million people are already without health insurance, and an even greater number are at risk of losing it as they face layoffs and employer cutbacks in benefits. Additionally, even among families who have health insurance, 22.3% currently spend more than 2.5% percent of their income on health care expenses not covered by their insurance; these copayments may be discouraging people from using necessary and preventive care.

Without real reforms to lower the costs, expand coverage, and increase the availability of care—especially preventive and primary care—these issues pose serious short- and long-term problems to the Nation’s health and to the budgets of local, state, and Federal governments. Our health care system is dangerously close to being out-of-reach and unaffordable for the majority of our citizens.

Solving these problems will not be easy, particularly during the current economic crisis, and the solutions will take a great deal of time and creative energy to implement.

Here in New York, the Foundation has been diligently working to identify and spread the implementation of solutions to this growing crisis, and has seen some positive effects. We have focused our efforts in two areas: finding ways to expand health coverage and working to expand the impact of primary care health centers and doctors throughout the State.

We gathered health care experts and advocates from across the region in November 2008 to discuss remedies to the high costs in the individual insurance market. In January 2009, we issued the first side-by-side comparison of the costs associated with five competing health insurance expansion plans. Both of these efforts helped define what is needed to insure the 2.5 million New Yorkers without health coverage and provided our lawmakers with the information they needed to pursue solutions.

We have also been working at the community level to strengthen health centers, particularly those that deal with chronic conditions like diabetes, and mental health and substance use issues. Helping primary care providers diagnose and treat these conditions significantly reduces the risks of more serious health complications, and as a result lowers costs for patients in the long run.

While these efforts have seen success across the State, they alone will not stem the rising tide of costs and the uninsured. Comprehensive reform efforts at the State and Federal levels are needed to truly tackle this issue. As the Kaiser Health Tracking Poll demonstrated, health care has already become unaffordable for half of our citizens. We must act now before that number grows.

James R. Knickman