Nonprofit, independent journalism. Supported by readers.


As recession holds down health spending, have you made choices to forgo or delay treatment?

“It’s possible patients are looking more critically at the care they are using,” said Stefan Gildemeister at the Minnesota Department of Health. “We need to wait until the [economic] recovery to see.”

Medical costs are down, but are people forgoing care?
REUTERS/Hyungwon Kang
Medical costs are down, but are people forgoing care?

Has the economy forced you to forgo or put off medical care? Have you postponed care or gone without it — even if you have insurance?

Evidence that you either have or will is mounting, according to local health economists and social welfare researchers.

On Monday, the U.S. Department of Health and Human Services reported that health-care spending, as a share of the overall economy, stabilized in 2010. People may be using less care for a variety of reasons, including more prevalent cost-shifting provisions in insurance policies, job loss and greater awareness of the true cost of care.

But the economy is doubtless a factor, the report found.

Article continues after advertisement

“Although medical goods and services are generally viewed as necessities, the latest recession has had a dramatic effect on their utilization,” the Associated Press (via the Star Tribune) quoted the report as saying. “Though the recession officially ended in 2009, its impact on the health care sector appears to have continued into 2010.”

Trend seems likely to hold or accelerate in MN
Minnesota health officials agree. Though they won’t have a corresponding local statistical portrait until June, researchers and economists say 2009 numbers [PDF] suggest the trend will either hold true or be accelerated here.

As in so many other arenas, Minnesotans have had farther to fall. In 2007, almost 81 percent of working-age Minnesotans had access to employer-sponsored insurance. By 2009, only 71 percent, did and a significant number had been forced onto high-deductible plans. Nationally, the number fell by 8 percent.

According to Minnesota Compass, a social indicators tracking project spearheaded by Wilder Research, average spending on health care by household in the 13-county Twin Cities metro area fell from $3,834 in 2007 to $3,354 in 2008 and $3,314 in 2009. At the national level, household spending on health care rose from $2,952 in 2007 to $2,966 in 2008 and $3,126 in 2009. 

According to the Kaiser Family Foundation, Minnesota’s 2009-2010 health spending per capita is $7,409, higher than the national rate of $6,815, and the average employee contribution to workplace family coverage is lower – at 23 percent versus 27 percent. Nine percent of the state’s population was uninsured during that time period, versus 16 percent nationally. 

Making cost-conscious choices?
There are those who argue that the stabilizing level of spending reflects growing consumer awareness of the need to make cost-conscious choices.

“It’s possible patients are looking more critically at the care they are using,” said Stefan Gildemeister, director of the Health Economics Program at the Minnesota Department of Health. “We need to wait until the [economic] recovery to see. It’s crucial to understand whether it’s a one- or two-year change or a change in the way we consume health care.”

More likely, he noted, any change in consumption patterns has been triggered by the decrease in insurance plans that do not require consumers to bear a greater share of the cost.

Lynn Blewett
Lynn Blewett

Economist Lynn Blewett is a professor in the Division of Health Policy and Management at the University of Minnesota’s School of Public Health and the director of the State Health Access Data Assistance Center.

“The data shows the movement is not because of cost-containment strategies,” she said. “That’s what people have in their head was supposed to happen, but it’s just not true.

Article continues after advertisement

“It’s the lack of ability to access health care at all.”

Have you postponed or forgone care, be it preventive, elective or simply out of reach? Scroll down just a few more lines to our comments thread and share your experience.