Friday, Aug. 29, 2008

Rising costs lead to less care

More people are going without prescriptions or other treatments

By BARBARA ANDERSON
The Fresno Bee

Families aren't just skipping prime rib dinners and trips to Las Vegas to save money these days. They're also economizing on prescription drugs, dental work and doctor visits.

More people say they've had problems paying for health care and insurance this year than just a few years ago. With prices high for gas, food and mortgages, many are skimping when it comes to staying healthy.

"We see it all the time," said Michael Winton, a Fresno pharmacist. "People shy away from getting their prescriptions filled because they've got to put food on the table."

A Kaiser Family Foundation survey this April found 37 percent of those surveyed said they or a family member had problems with the cost of care. They skipped a recommended test or treatment. Or they didn't fill a prescription, or cut pills in half or skipped doses. Or they had problems getting mental health care.

And 66 percent said doing without care, or delaying it, made their health worse.

Researchers say that's a significant change since 2005. That year, 31 percent reported skipping tests, not taking pills or cutting them in half, or having problems with mental health care because of the cost. At that time, 42 percent said the lack of care had affected their health.

Karin and Andrew Livingstone, of Yosemite Lakes Park, put off thousands of dollars of dental work this year when the price of gasoline increased and Andrew's home maintenance and flooring business slowed down.

Dental work is not on the priority list, said Karin Livingstone, 35. She needs an implant and a crown for two teeth. Andrew, 46, needs a series of dental repairs. The couple has no insurance.

With the family business earning less and the cost of gas and food rising, "we're prioritizing many things in our lives right now," Karin Livingstone said.

The health of their two daughters, Hannah, 6, and Emma, 3, takes precedence, she said. "We chose to get the girls' teeth taken care of first." Changes in the economy affect people without health insurance and low-income families more than others. Almost half of people earning less than $30,000 a year said they had serious problems paying for health care, according to the 2008 Kaiser survey.

But even middle-income people are reporting problems. Nearly 30 percent of people surveyed with incomes between $30,000 and $75,000 a year said they had difficulty paying for health care.

Insurance doesn't guarantee someone will be able to afford health care, said Mollyann Brodie, vice president and director of public opinion and survey research at Kaiser.

Insurance costs keep increasing, putting them out of reach of many families, said Jeff Goldsmith, president of Health Futures Inc., and an associate professor of public health sciences at the University of Virginia who lectures on health services management and policy.

For example, families in 1999 paid an average of $129 a month in insurance premiums, Goldsmith said. In 2007, the cost was $273.

The Livingstones shopped for private insurance. Their daughters qualify for Medi-Cal, the state insurance program for low-income families, but private insurance for themselves would cost $800 to $1,500 a month in premiums, said Karin Livingstone. "We just can't afford that right now," she said.

Employers who offer group health insurance to employees say it's getting harder to keep it affordable.

Wade Haines, owner of the Madera County trucking firm Fred Haines and Company Inc., said skyrocketing insurance premiums make it necessary to pass along some costs to workers.