According to a 2005 survey by the Employee Benefit Research Institute and the Commonwealth Fund, greater percentages of health care consumers in high-deductible plans spend more than 5 percent of their income on out-of-pocket medical expenses and insurance premiums. For those with household incomes below $50,000, the numbers are even starker: 92 percent of people in high deductible plans spent more than 5 percent of income on out-of-pocket expenses and premiums, while 34 percent of those with comprehensive insurance did so. Medical bill problems and medical debt are more frequently reported by people in higher deductible plans. As these types of plans proliferate, out-of-pocket expenses could grow even more, thus increasing the potential for medical debt.
Oh, but the credit card companies have an answer:
In recognition of the growing market for patient out-of-pocket costs, the credit card industry has developed “medical credit cards” designed specifically for medical expenses, which have recently entered the marketplace. In some cases, health insurers and financial institutions are teaming up to offer products featuring high deductible health insurance and lines of credit to meet the increase in out-of-pocket expenses associated with the higher deductible. Several HSA servicers are now incorporating integrated lines of credit into their HSA products. That there is a market for credit cards specifically designed for these out-of-pocket costs indicates that patients are having difficulty meeting these expenses. To the extent that interest rates or penalty fees are applied to these expenses when credit cards are used to meet them, patients are paying even more. In other cases, credit card companies are working in conjunction with health care providers to shift bill collection from the provider to the credit card company, and are offering incentives such as bill discounts for patients who use the credit card, particularly uninsured patients. Many of these credit cards charge interest, and, like traditional consumer credit cards, a late payment can trigger penalty rates and fees, thus exacerbating medical debt. In a deregulated lending environment, once medical debt is subsumed under credit card debt, it is subject to the same maze of terms, conditions, and fees to which all consumer credit card debt is subject. More oversight of this burgeoning industry is needed to protect consumers from medical credit card debt.
It is these very kinds of abuses of people in their weakest moments of life that shows we cannot go with a privately funded health care system. Patients need to focus on getting well. The stress that results from worrying about paying for medical debt -- especially when someone is sick or injured and cannot work -- only compounds the injury or illness. Increased stress levels impede the body's natural disease-fighting mechanisms. Our current health policy of burdening the patient with more medical debt is like kicking someone when they are down.
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