Scrimping on health care

More Americans are skipping doctor visits and scrimping on prescription drugs to save money, a new survey has found.

The survey, released today by the Consumer Reports National Research Center, found that the percentage of people who reported cutting corners on their health care rose from 39 percent to 48 percent over the past three years. The poll was conducted this past June and involved a representative sample of 1,200 adults.

The findings reinforce what many observers have been saying all along: Consumers are pressured by health care costs and some of them are opting to delay or forego care, perhaps unwisely.

- 21 percent of the survey participants said they had delayed seeing a doctor because of the cost.

- 16 percent didn’t fill a prescription.

- 12 percent skipped a scheduled dose without first discussing it with their doctor or pharmacist. (The poll unfortunately wasn’t designed to examine whether those who reported skimping on care ended up with health consequences down the road.)

- Survey respondents in lower income brackets were more likely to cut corners than those who earned more.

- Although generic drugs are cheaper than name-brand versions and their use is widespread, 41 percent of the respondents said their doctor only sometimes – or never – recommended a generic. The survey also uncovered misconceptions about generic drugs; nearly 40 percent of the participants expressed concerns about the safety and effectiveness of generic drugs, suggesting a need for more education on this front.

- In most cases, the cost of prescription drugs was not discussed during the visit with the doctor. Two-thirds of the survey respondents didn’t know what their medication would cost until they picked it up at the pharmacy.

- The majority of those surveyed said they were concerned about the influence of the drug industry on physicians’ likelihood to issue prescriptions – but it appears patients also can be swayed by drug advertising. Eighteen percent of the respondents said they had asked their doctor to prescribe a drug they saw advertised, and the majority of the time they received it.

What can patients do to ensure they’re spending wisely on prescription medications? Consumer Reports offers some advice: If you’re concerned about the cost, bring it up with the doctor, especially if it involves a medication you’ll need to take long term. In many cases you might be able to substitute with a generic. Pharmacies also can help with discounts, or help connect you with programs that offer lower-cost prescription medications.

The Consumer Reports survey doesn’t let clinicians off the hook either, noting that they need to be more aware of the financial impact of their decisions. Some studies in fact suggest that nine out of every 10 health care dollars spent in the United States is ultimately determined by health care providers rather than by patients.

Although this survey underscores how cost-conscious many people are when it comes to health care, it makes another point that’s┬ásubtle but important: When consumers pay more out of pocket for health care, it might force them to think twice before spending the money but it doesn’t guarantee they’ll be smarter or more well-informed, or that they’ll make better choices. Furthermore, what looks like a short-term cost saving could turn out to be more expensive in the long run, particularly if people are skipping medications they truly need. If the Consumer Reports poll is any indication,┬áthere’s still considerable work to be done on how we approach the entire monster issue of health care costs.

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