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Fallout: The Financial Crisis

When you can’t afford care you need

Ashley Milne-Tyte Nov 4, 2008
Fallout: The Financial Crisis

When you can’t afford care you need

Ashley Milne-Tyte Nov 4, 2008


Kai Ryssdal:
Once the economy’s taken care of, whoever wins tonight gets to move on to his own priorities.
The wars in Iraq, global warming, immigration, health care, perhaps.
While we don’t know yet exactly how health care might change, we do know a few things about a key part of the health care industry.
After years of hefty profits, Big Pharma is growing at a measly 1 or 2 percent annually. Partly because patents on some top-earning drugs are about to expire.
Partly also because of the economy and Americans who can’t afford to fill prescriptions anymore. Ashley Milne-Tyte reports on making cuts where it hurts.

Ashley Milne-Tyte:
Julia Koponick lives outside Portland, Oregon. She’s overseeing her daughter Sarah’s after-school snack.

Julia Koponick: OK, come finish eating your apple, sweetie.

Sarah: This one’s too big.

Koponick: You want me to cut it into two pieces?

Sarah: M’hm.

She has three children and another one on the way. She’s having a tough pregnancy. She’s racked up thousands of dollars in out-of-pocket costs for ER visits and hospital stays, even though she has insurance. And her family’s used up their savings. She and her husband recently sold their house at a big loss. Now the company where he works is being sold, and his job could be in jeopardy.

Koponick: There are several of my medications that we’ve just decided that we’re just not going to get filled right now because they’re not directly related to the medical problems with the pregnancy. And certainly it’s, you know, more comfortable not to have heartburn, but the co-payments for some of those medications are pretty high and we just don’t have the money in our budget to do that.

Koponick says her husband’s also putting off dental work he needs. All this sounds familiar to Dr. Ted Epperly. He’s president of the American Academy of Family Physicians. He says, since the economy started to sour, Americans have been going without more than medications.

Ted Epperly: We’ve seen a definite decrement in patients’ visits, and we’ve seen patients cancel appointments, not getting as many tests.

Jon Haas is one of those patients. He and his wife run a financial consulting firm in central Florida. Both are in their 50’s. In February, they lost their biggest client. Haas says they had a choice: drop their $1,500-a-month health insurance policy or go out of business.

Jon Haas: And it was one of those things that I looked at and said you know, I really don’t wanna do this. You’re at the stage in life where you absolutely need your health insurance. And yet it’s the one thing you really can’t afford.

Haas is on about 12 drugs for ailments including arthritis, colitis and bronchial problems. Or rather he was. Since he canceled his insurance, he’s cut his prescriptions in half. He’s dropped his colitis medication altogether because it costs $400 a month. He’s getting generic versions of some other drugs. They cost $10 to $12 for a few months’ supply at Walgreens or Wal-Mart. He’s also negotiated with some of his doctors to lower his fee.

Haas: And then, of course, you beg for samples, so it helps offset, you know, the other expenses that you run into. And then, forget about preventative medicine, that’s no longer on the table.

Haas says he’s skipping some of his annual cancer screenings and blood tests.

People with a lot of health problems, like Haas, may suffer during a bad economy, but in general, Americans tend do be healthier during a downturn.

Christopher Ruhm is an economics professor at the University of North Carolina. He’s done several studies on health during hard times. He says fewer people die from heart attacks and heart disease during an economic slump. He says people change their lifestyles when money’s tight.

Christopher Ruhm: They drink less, they smoke less, they’re less likely to be obese. They actually exercise more.

Ruhm admits plenty of people do badly in tough times, especially if they have no insurance. But others take better care of themselves, he says, because they finally have time to concentrate on their health. He says, if that happens this time around, it will be one good thing to come out of the recession.

I’m Ashley Milne-Tyte for Marketplace.

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