A new analysis suggests the cumulative financial strain of healthcare is more widespread than annual snapshots indicate — and most Americans will experience unaffordable costs during their lifetimes.
The study, published Dec. 22 in JAMA Internal Medicine, was conducted by researchers from Harvard Medical School in Boston, the City University of New York’s Hunter College and Public Citizen’s Health Research Group. Using longitudinal data from the Medical Expenditure Panel Survey (2018-2022), the team tracked 12,645 U.S. adults and analyzed their experiences with several indicators of healthcare financial strain.
The researchers examined three specific burdens: “cost burden” (out-of-pocket costs exceeding 10% of family income, or 5% for low-income households); “catastrophic cost burden” (out-of-pocket costs exceeding 40% of post-subsistence income); and “foregone care due to cost” (not receiving needed medical care because of affordability issues). Individuals experiencing any one of the three were considered to have encountered financial strain from healthcare.
Over four years, 26.7% of adults reported experiencing either cost burden or skipping care due to costs. Factors such as low income, lack of insurance, chronic illness, and hospitalizations were associated with higher risk. Notably, among the 2.3% of participants who died during the study, more than half (53.2%) had encountered financial strain in the one to four years before death.
Lead author Adam Gaffney, MD, a critical care physician and assistant professor at Harvard Medical School, said in a news release that the findings show healthcare affordability is a chronic issue that builds over time — and that many Americans eventually will be affected.
“High medical costs don’t just devastate finances, they force people to skip care — which often further worsens their health,” Dr. Gaffney said in a release shared with Becker’s.
The authors acknowledged limitations of the study, including the exclusion of insurance premium costs and nursing home residents from the analysis.
Read the full study here.
