Half of Americans cannot afford prescribed medications

By Tom Eley
28 September 2011

A new study by Consumer Reports has documented a dramatic increase in the number of Americans forgoing needed medications and health care for financial reasons.

The Consumer Reports National Research Center found that over the last year nearly half of all Americans (49 percent) who were prescribed medication and other health procedures reported holding back for financial reasons, up from 39 percent a year earlier.

Coming on the heels of census data showing a sharp increase in the ranks of the uninsured to 49.9 million, the Consumer Reports survey is yet another exposure of the right-wing character of the Obama administration’s health care “reform,” which will do nothing to rein in health care costs. More than one-and-one-half years after its passage, access to health care has become more financially onerous.

The study found that among the 49 percent of respondents who reported avoiding recommended health care, 28 percent put their own health at significant risk in order to save money, including 16 percent who did not fill a prescription, 13 percent who took expired medication, 12 percent who skipped scheduled doses without medical consultation, 8 percent who took to cutting pills in half, and 4 percent who reported doubling up on medication with someone else.

Another 21 percent reported delaying a doctor’s visit, and 17 percent delayed a prescribed medical procedure. Fourteen percent refused prescribed medical tests.

The study found a decline in average household out-of-pocket expenditure on drugs from $68 two years ago to $59. Consumer Reports attributed this to “household budget constraints.”

“The rising percentage of people putting off health care makes us wonder if we are really done with the recession,” said Dr. John Santa, a physician with Consumer Reports’ Health Ratings Center. “This is one of the most sensitive barometers of how people are coping with the financial pressures.”

The study offers a window on a vast public health catastrophe. According to one estimate, about half of all Americans, 49 percent, currently take a prescription drug. Consumer Reports data suggests that half of this category, again 49 percent, forgo needed medical treatment due to cost. Thus roughly a quarter of the population, 75 million people, are not complying with medical advice for financial reasons.

The consequences of this are doubly concentrated on the working class and poor because these sections of the population both most need and can least afford medical treatment: consumers earning less than $40,000 and those over the age of 65 years are the demographics that are prescribed the most medications, at 5.7 per consumer and 5.5 per consumer, respectively.

The Consumer Reports study comes after an August survey by the Commonwealth Fund, which found that nearly 75 percent of people who lost health insurance when they recently lost their jobs were forced to skip treatment or medication because of cost. In April, the Kaiser Family Foundation released a study revealing that 33 percent of Americans skipped dental care the previous year because they could not afford it. In 2003, the US surgeon general reported that 108 million Americans had no dental insurance; the number is certainly far higher now.

“People want to believe there’s a safety net that catches all of these people, and there isn’t,” said Dr. Glenn Stream, president-elect of the American Academy of Family Physicians.

Indeed, tens of thousands of people die each year in the US for lack of health care. In 2009 the American Journal of Public Health estimated that 45,000 deaths per year in the United States are associated with the lack of health insurance. This is about 12 times the number of Americans killed in the 9/11 terrorist attacks, whose deaths have been used to justify trillions of dollars in spending on wars and the military. In 2010 the health care advocacy group Families USA predicted that, over the coming decade, as many as 275,000 Americans will die for lack of health care coverage.

One recent example of the tragic results of this crisis is the death of 24-year-old Kyle Willis of Cincinnati. Willis’s wisdom tooth started to cause discomfort in mid-August. The pain and swelling became so severe that he had to go to the emergency room, where he was prescribed antibiotics and medications. Willis, who was unemployed and had no health insurance, could not afford both, and so chose the pain medications for relief.

The infection spread to Willis’s brain and killed him on August 30. The aspiring paralegal left behind a six-year-old daughter.

“When people are unemployed or don’t have insurance, where do they go? What do they do?” asked Dr. Irvin Silverstein, a dentist at the University of California at San Diego, commenting on Willis’s death. “People end up dying, and these are the most treatable, preventable diseases in the world.”

“[Willis] might as well have been living in 1927,” said Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University. “All of the advances we’ve made in medicine today and are proud of, for people who don’t have coverage, you might as well never have developed those.”