Health Care You Can’t Afford Not to Afford

By WALECIA KONRAD
17 jan 2009--With the recession in full swing, more and more Americans seem to be putting their health-care needs on the back burner as they struggle to handle monthly bills and day-to-day expenses.

About one in three Americans say their family has had problems paying medical bills in the past year, according to a recent poll by the Kaiser Family Foundation, a nonprofit research group focused on health care. More alarming, almost half of those surveyed said someone in their family was postponing or cutting back on medical care they said they needed.

If you or your family are forced into this type of economic triage, you’ve got to do it wisely, says Dr. Ted Epperly, the president of the American Academy of Family Physicians.

The truth is, some health care can probably be safely put off until you’re feeling more flush. If you’re due for your annual physical, for instance, and you feel fine, you can wait a few months before forking over that hefty co-payment. Even children, once they are past vaccination age, can skip a check-up or two, as long as they are healthy and at a normal weight.

And while this suggestion is surely controversial, some experts say routine screenings like mammograms for women or PSA tests for men can also be postponed for a few months, as long as the person doesn’t have any symptoms and no family history of health problems in these areas. “The American Cancer Society wouldn’t like me saying so,” Dr. Epperly said, “but you can stretch out those tests when you need to.”

But the things you can safely skip make a far shorter list than the treatments most health care professionals consider mandatory — no matter how cash-strapped you may be. The following three areas of health care are ones you simply can’t afford to ignore, not only for your immediate well-being, but to avoid even more costly crisis care later. Fortunately, as you’ll see below, there are ways to get help paying for the care you need.

1. Your Medicine More than a third of the people in the Kaiser survey said they were splitting pills, skipping doses of medicine or not filling prescriptions in the first place. “If you’re suffering from a chronic illness such as high blood pressure, diabetes or asthma, you already know how important taking your medicine is,” Dr. Epperly said. “You’re on these medications for a reason, and going off without a physician’s advice will almost always make you sicker.” Even seemingly minor illnesses like strep throat or an ear infection can turn into an emergency room visit if left untreated.

What you can do: If you’re having trouble affording your medicine, talk to your doctor immediately. He or she may be able to switch you to a less expensive alternative or a generic version of the drug you’re now taking. “Generics have the advantage of being much cheaper,” said Dr. Sydney Wolfe, the director of health research for the consumer advocacy group Public Citizen. “But they are also often safer than new, brand-name drugs because they have been in use long enough for potential side effects to be known.”

Your doctor may also be able to help you enroll in a prescription drug aid program like the one sponsored by the Partnership for Prescription Assistance, a coalition of pharmaceutical companies and health-care advocates, says Cheryl Fish-Parcham, the deputy director of health policy at Families USA, another consumer advocacy group.

Another good source for help with finding affordable prescriptions (and all types of medical financial assistance) is MedlinePlus, a Web site backed by the National Library of Medicine and the National Institutes of Health.

2. Your Symptoms Delaying care can work for fully healthy people. But the minute you have symptoms or start to feel something is wrong, that all changes, says Dr. Epperly. Skipping tests and treatments is no longer an option. Still, even if the doctor thinks you really do need an expensive diagnostic test, like a CT scan or M.R.I., there may be ways to get it done at reduced cost.

What you can do: Ask your doctor about free screening programs and low-cost clinics in your community that can provide an affordable test. In New York City, organizations like the Community Service Society offer resources for finding low-cost care. Also, if your test or treatment is related to a specific illness like Crohn’s disease or diabetes, look up the Web site for the association or foundation that specializes in that illness, Ms. Fish-Parcham says. These organizations often provide resources for financial assistance to patients in need.

3. Your General Well-Being When you’re feeling out of control financially, it’s easy to let good habits and routines go out the window and resort to a vice or two. But this is not the time to smoke or drink more, Dr. Epperly advises. You could blow the budget and maybe cause real problems down the line.

What you can do: Keep eating a healthy diet, get plenty of exercise and get a good night’s sleep. “All three of these low-cost treatments have proven health benefits for you,” Dr. Epperly said. And all that healthy living may help you relieve some of the stress you’re feeling about money.