Saturday, August 22nd, 2009

People with no insurance putting off doctor visits

By Shelley Grieshop
Adults who've been left with little or no medical benefits due to job losses or hourly cuts could be putting their health in jeopardy.
Some area physicians say a substantial number of adult patients are delaying office visits and treatment because they no longer have adequate medical insurance coverage. The result often leads to advanced illnesses and hospitalizations that could have been avoided, doctors say.
"There's no doubt that's happening these days," says family physician Dr. Philip Masser, who also is the Mercer County health commissioner.
Masser said he's had several patients who've been hospitalized for illnesses or injuries that likely could have been treated in-office if they'd sought treatment sooner. He's also getting used to "negotiations" with patients for treatment plans they can afford.
"They may say, 'Doc, I'm having this back pain, but I have no insurance and don't want any expensive tests,' " Masser said.
The problem isn't as common for children because there are numerous government-supported programs for which they qualify. But uninsured or underinsured adults - particularly those without children - have relatively few safety nets, says Lena Goldenetz, a financial assistant at Auglaize County Job and Family Services.
"Children usually meet eligibility for our programs but often not their parents," she explained, although pregnant mothers are an exception.
Goldenetz said the agency typically can help provide some type of medical care assistance to most adults who come through their doors. The toughest cases involve those whose income was drastically decreased by a lay-off or a move from full-time to part-time status, and those who aren't offered insurance extensions by their employer, she said.
Some individuals discover they make too much money through unemployment to qualify for any state of federal medical assistance, Goldenetz said.
Government programs such as the Consolidated Omnibus Budget Reconciliation Act (COBRA) are an option for some, but the expensive premiums can take more than 75 percent of an individual's monthly unemployment income, according to Families USA, a consumer health care organization.
Dr. Jean Thresher, a local board certified obstetrician/gynecologist, says there are "mechanisms in place" locally to help people get the care they need, when they need it, regardless of their financial situation.
"No one around here is turned away for lack of money," she said. "That doesn't mean you won't be left with a bill to pay. It just means there is no reason not to get the care you need."
Thresher said women who put off regular preventative tests such as "the big three" - mammograms, pap smears and colonoscopies - are putting themselves at risk. All three tests can pinpoint cancers and other problems that are treatable if found in the early stages.
"We can prevent so much these days," she added.
Thresher said patients should be upfront with their health care providers about their financial status. Those who need help such as payment options for out-of-pocket expenses need to speak up, she said.
"We try to be compassionate and understand everyone's unique situation," Thresher said.
A recent survey by the Ohio State Medical Association revealed that nearly 90 percent of Ohio doctors have seen an increase in patients who are struggling to pay their medical bills. About 70 percent say they've experienced a decrease in business and/or an increase in cancellations due to the poor economy.
Three out of four doctors surveyed said they offer payment plans to patients who struggle financially.
Masser said most area doctors have done that for years.
"We've always worked with people," he said. "And there's no question we're doing it much more now."
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