Higher Bills Are Leading Americans to Delay Medical Care

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About one-fourth of respondents in Gallup’s poll said they put off care last year for what they considered a “serious” condition. When Margaret Bell, 71, found that her cancer had returned four years ago, she hesitated to resume her chemotherapy because she could not afford it, and higher prices have made it even harder. She would regularly skip appointments near her home in Lancaster, S.C.

“It is impacting patients’ access to care,” Ms. Bell’s oncologist, Dr. Kashyap B. Patel, said. As the chief executive of Carolina Blood and Cancer Care Associates in Rock Hill, S.C., he recently set up a nonprofit group, No One Left Alone, to help cancer patients like Ms. Bell and to connect them with local charities. The organization is covering the cost of her treatments, and Dr. Patel has assured her that his office will find the money for her visits.

On a limited budget, “it’s been very difficult for me,” Ms. Bell said. Having her family over for dinner can be a strain because of high grocery bills, and she is faced with deciding which of her medical needs is the most urgent. She has postponed receiving a pacemaker.

A new federal report suggests fewer Americans’ health bills are being sent to collection, but medical debt still accounts for more than half of all kinds of collection debt, exceeding unpaid credit card or cellphone bills. It remains a serious issue: about a fifth of Californians said they had medical debt of at least $5,000, according to another recent survey. A little over half of those asked said they had skipped some kind of care in the last year, with half of those reporting their condition got worse as a result.

“This is about trade-offs that people have to think about that are really hard,” said Dr. Jay Bhatt, the executive director of the Deloitte Center for Health Solutions, a research unit of the consulting firm. He also sees patients at the Family Christian Health Center outside of Chicago. In a survey by Deloitte last year, 28 percent of respondents said they were less able to afford care than in the previous year.

Some of the clinic’s patients are losing their jobs and insurance, he said. “We’ve seen this before, and we are going to see it in big numbers now,” Dr. Bhatt said.