By Jill E. Kovacevich, Executive Director of Doctors Plus, Inc.
Shortages of affordable care access in our community affect everyone, including the uninsured, the insured and underinsured – and results in negative health outcomes. Affordability of health care is measured both objectively, based on costs paid in excess of 10% of an individual or family’s income, and subjectively, by whether patients’ have refused care because they were unable to pay.
In Colorado, our uninsured and underinsured patients have been found more likely to forego a physician visit because of cost. One in three Coloradans has reported being unable to pay a medical bill – creating a barrier to needed follow-up care. Fifty percent of all patients, with and without insurance, have reported cost as a barrier to their needed care. These same patients have the lowest rate of acquiring a usual source of care and often use our emergency rooms as a last resort, resulting in staggering medical debt for them. Costs of health care are a challenge for all Coloradans. A recent study found 36% of the patients at 40 Colorado practices, with insurance, and presumably affordable care access, refused at least one type of needed care based on cost. Further, of those underinsured patients (with high deductibles or high out of pocket costs) who reported fair or poor health, 20% had insurance coverage under employer plans.
We cannot presume patients have access to care they can afford. Over 1.5 million Coloradans are uninsured or underinsured and these numbers are expected to increase as deductibles and unemployment continues to rise. Everyday we hear stories at our clinic of patients’ experiencing access barriers to care due to cost. The most unfortunate are those patients that forgo needed treatments because of cost – and suffer life-threatening consequences. At one clinic in Eagle County, a patient, in a single wage-earner household with a high deductible insurance plan, told us she refused a needed colonoscopy due to cost, after being told she needed to pay $600.00 on the day of service. She was then treated several months later as her symptoms got worse, and following that she was diagnosed with colon cancer.
These stories are the reason we do what we do at Doctors Plus. We help people get the care they need, when they need it. The Hospital Payment Assistance Program (SB12-134) will help all Coloradans by providing them information on the financial assistance programs hospitals offer the uninsured and underinsured, and limit hospital charges and collection practices for the low-income uninsured. Passing SB12-134 can help change the devastating stories we hear every day.
The Colorado Trust
Colorado Health Access Survey
Journal of the American Board of Family Medicine
Colorado Health Institute
Colorado General Assembly, SB12-134