If you’re feeling the pinch of skyrocketing out-of-pocket health care costs, you aren’t alone.
Across the country, millions of patients with “good” health insurance are being hit with higher out-of-pocket costs every time they go to access their health care. By one independent estimate, health care deductibles have quadrupled over the past 12 years. Not surprisingly, as insurance companies have shifted more health care costs to patients, insurance company profits have soared.
“Patients with great insurance are shocked when they find out just how little their insurance really covers,” says Terry Wilcox, executive director of Patients Rising, a national patient advocacy non-profit that helps patients overcome insurance barriers to access. “Health insurance isn’t the same thing as health care.”
Earlier this year, a Los Angeles Times investigation shed light on the health care affordability crisis facing millions of patients with health insurance.
“In the last 12 years, annual deductibles in job-based health plans have nearly quadrupled and now average more than $1,300,” the Los Angeles Times reports. “Soaring deductibles and medical bills are pushing millions of American families to the breaking point, fueling an affordability crisis that is pulling in middle-class households with health insurance as well as the poor and uninsured.”
In 2006, patients with insurance provided by their employer paid an average deductible of just $379, according to the Times report. By 2018, that deductible had risen to $1,350.
$4,659 Average Out-of-Pocket Cost for Inpatient Care
Out-of-pocket costs are even greater for patients that require inpatient care.
Between deductibles and co-pays, the average patient paid $4,659 for an inpatient visit in 2018, according to a report from TransUnion Healthcare. That’s a $572 increase compared to 2017, when patients paid out $4,086 for an inpatient visit.
“The original idea of deductibles and co-pays theoretically might have made sense — if patients have more responsibility for how they spend medical dollars, they would be more careful,” explains Barbara McAneny, president of the American Medical Association, the nation’s largest physicians’ organization. “But it is just shifting costs to the patients, and people are forgoing care they need.”
High Out-of-Pocket Costs Cause Patients to Skip Care
Rising out-of-pocket costs are having a negative impact on patient health. Oncologists warn that many cancer patients skip treatments because they cannot afford the high out-of-pocket costs imposed by their insurance companies.
“There are drugs that we know work,” points out Dr. S. Yousuf Zafar of the Duke Cancer Institute in North Carolina. “But patients aren’t taking them.”
According to a nationwide Los Angeles Times and Kaiser Family Foundation poll of people with job-based coverage, half of all U.S. patients with employer-provided health insurance say “they or an immediate family member have delayed a doctor’s appointment, not filled a prescription or postponed some other medical care in the last year because of cost.”
A 2018 survey by the West Health Institute/NORC at the University of Chicago found that as many as 44 percent of Americans avoided going to the doctor when they were sick because of the cost.
“Patients are desperate for real and meaningful health care reform,” says Wilcox of Patients Rising. “We need to bring down the real costs that patients pay when they access care.”
UnitedHealthCare: Stock Price Soars as Patients Suffer
By forcing insured patients to pay more out-of-pocket, insurance companies have seen skyrocketing profits.
Last year, UnitedHealth Group reported annual gross profit of $53.846 billion. Its stock price has also seen extraordinary growth.
In August 2009, UnitedHealthCare’s stock price closed at 28.34. Today, it sits at $248.63. That’s a 777 percent increase in just the past decade.