Managed Care

Medical debt found to hinder access

New findings from the Center for Studying Health System Change's 2003 Community Tracking Study Household Survey indicate that an increasing number of Americans face the serious consequences of medical debt.

Almost two thirds of all families with medical bill problems reported difficulty paying for other necessities — rent or mortgage, transportation, food — as a result of medical debt. "Families that want to avoid further medical debt may forego needed medical care because of out-of-pocket costs," says Peter J. Cunningham, PhD, a senior health researcher at the center.

The concern, however, is the future, as the number of American families with problems paying medical bills is likely to increase. With the emergence of consumer-directed health plans, both privately and publicly insured people will probably face growing out-of-pocket medical costs. Medical bill problems may limit the appeal of the new health savings accounts passed as part of the 2003 Medicare reform.

The appeal of HSAs may be limited to high-income families that have both greater resources and a greater tax incentive to contribute to accounts. HSAs may not be much help to families of modest income with medical debt, unless their employers fund the accounts generously.


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