Health care costs remain problematic for many

Published 5:28 pm Thursday, January 16, 2020


The Advocate-Messenger

According to a new study, a third of rural adults struggle to pay their medical and dental bills. 

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The study, “Views of Rural U.S. Adults About Health and Economic Concerns,” was published by the JAMA Network Jan. 8, and included data from surveys of 1,300 adults in 2018 and 1,405 adults in 2019. 

Thirty-two percent of respondents reported having difficulty paying their medical bills, and 19 percent reported major problems. 

Among adults with lower incomes (less the $25,000 annually), 44 percent cited problems affording medical bills or dental treatment. 

Additionally, 26 percent said there was a time the past few years they needed health care, but did not get it, including 24 percent of adults with health insurance. 

Forty-five percent of those who did not receive care said they did not seek care because they could not afford it. Another 23 percent cited problems with access to care, 22 percent reported difficulty getting appointments and 19 percent reported they could not find a physician who would accept their insurance. 

Nearly half of respondents said they would have difficulty paying off an unexpected $1,000 expense. 

“One in three rural adults still have problems paying their medical bills even after the passage and implementation of the Patient Protection and Affordable Care Act,” the report states. “During the past decade, we found that one-fourth of rural adults still reported problems with health-care costs and access. Inability to pay medical bills and problems with access to health care remain significant burdens for rural adults.”

Learning that rural Americans struggle with access and affording health care is concerning, considering they face numerous health disparities compared to their urban counterparts. 

According to the U.S. Census Bureau, more than 46 million Americans, or 15 percent to the U.S. population, live in rural places. 

The Centers for Disease Control and Prevention report that rural Americans are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke than urban Americans. 

“Unintentional injury deaths are approximately 50 percent higher in rural areas than in urban areas, partly due to greater risk of death from motor vehicle crashes and opioid overdoses,” according to the CDC. “In general, residents of rural areas in the United States tend to be older and sicker than their urban counterparts.”

There is an obvious need to improve access to care for rural Americans, especially in Kentucky, which ranks as one of the least healthy states. 

Beyond access to care, Americans need to be able to afford care, which remains a struggle for many low-income individuals who live in rural areas. 

However, costs for health care continue to increase. A report from Access One released in November found out-of-pocket costs increased by 14 percent in 2018. More than half of survey respondents reported they spent at least $1,000 on medical care in the past 12 months, and 38 percent said they spent more than $2,500 on health bills.

Another study from the UnitedHealth Group found prices for inpatient care at hospitals rose 19 percent from 2013 to 2017, while physician prices for the same services rose 10 percent in the same time period. 

Unfortunately, rising costs of health care are prompting many rural Americans to skip care altogether, which is leading to worse health results for some of the least healthy Americans as it is. 

“Although rural communities have traditionally been self-reliant, more than half of rural adults are open to outside help to solve serious problems facing their communities, including major help from government,” according to the study.

One way to improve outcomes for rural Americans is to increase transparency about the cost of care. Price transparency laws have been introduced at the state and federal levels, and would benefit patients who would then be able to shop around for the most affordable care. 

Additionally, state and federal governments should look at opportunities to improve access to care in rural areas. Moreso, access to quality and affordable care will be essential to improving the health of some of the country’s most vulnerable people.