Skimping on health care

The economic recession is causing many to skimp on routine, preventive health care. Among diabetics, the trend is especially worrisome as cutting back on care can be life-threatening.

The Associated Press, in an article published April 13 by the Harrisburg Patriot-News, reports that doctors nationwide are seeing a drop in regular appointments with diabetic patients. Often, such patients will instead seek tax-subsidized or charity care. If unsuccessful, they end up in emergency rooms, sometimes in critical condition.

The article reports the experience of Eileen Collins, a 48-year-old resident of Indianapolis. She tried to scrimp on her medications after her husband lost his job and with it their insurance. Without money for insulin, test supplies and other medicines, she asked for free samples and also got a few drugs through a $4-a-month generic program. But she stopped taking most drugs and cut her insulin doses in half.

By late November, she was in the emergency room, vomiting blood and in diabetic ketoacidosis, a life-threatening condition. An expensive hospitalization followed.

In its April 12 edition, the Patriot-News also reported a related development: people with health insurance who are cutting back on medical care because they can not handle the high deductibles and co-pays.

So-called consumer-driven health insurance plans, which usually require the patient to bear responsibility for a large share of initial medical costs, don’t work well during a downturn in the economy, according to Carolyn F. Scanlan, the president and CEO of the Hospital and Healthsystem Association of Pennsylvania (HAP). People who are already short of funds due to unemployment or reduced hours are more likely to skip the health care they need, including preventive care such as mammograms, if they are covered by a health plan that requires the patient to pay substantial up-front costs.

According to hospital officials, consumer-driven plans are a major reason why normal medical visits are going down while emergency visits are rising. This also is causing a statewide rise in charity care and in bad debt involving unpaid medical bills.