Americans’ Challenges with Health Care Costs

Link: https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/

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  • About half of U.S. adults say it is difficult to afford health care costs, and one in four say they or a family member in their household had problems paying for health care in the past 12 months. Younger adults, those with lower incomes, adults in fair or poor health, and the uninsured are particularly likely to report problems affording health care in the past year.
  • The cost of health care can lead some to put off needed care. One in four adults say that in the past 12 months they have skipped or postponed getting health care they needed because of the cost. Notably six in ten uninsured adults (61%) say they went without needed care because of the cost.
  • The cost of prescription drugs prevents some people from filling prescriptions. About one in five adults (21%) say they have not filled a prescription because of the cost while a similar share say they have instead opted for over-the-counter alternatives. About one in ten adults say they have cut pills in half or skipped doses of medicine in the last year because of the cost.
  • Those who are covered by health insurance are not immune to the burden of health care costs. About four in ten insured adults worry about affording their monthly health insurance premium, and 48% worry about affording their deductible before health insurance kicks in. Indeed, large shares of adults with employer-sponsored insurance (ESI) and those with Marketplace coverage rate their insurance as “fair” or “poor” when it comes to their monthly premium and to out-of-pocket costs to see a doctor.
  • Health care debt is a burden for a large share of Americans. About four in ten adults (41%) report having debt due to medical or dental bills including debts owed to credit cards, collections agencies, family and friends, banks, and other lenders to pay for their health care costs, with disproportionate shares of Black and Hispanic adults, women, parents, those with low incomes, and uninsured adults saying they have health care debt.
  • Notable shares of adults still say they are worried about affording medical costs such as unexpected bills, deductibles, and long-term care services for themselves or a family member. Additionally, about half of adults would be unable to pay an unexpected medical bill of $500 in full without going into debt.

Author(s): Lunna Lopes, Marley Presiado, and Liz Hamel

Publication Date: 21 Dec 2023

Publication Site: Kaiser Family Foundation

2022 Employer Health Benefits Survey

Link: https://www.kff.org/health-costs/report/2022-employer-health-benefits-survey/

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This 24th annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices. The 2022 survey included 2,188 interviews with non-federal public and private firms.

Annual premiums for employer-sponsored family health coverage reached $22,463 this year, with workers on average paying $6,106 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,763 for single coverage. Workers at smaller firms contribute on average contribute nearly $2,000 more toward the cost of family coverage than workers at smaller firms. They also face general annual deductibles that are $1,000 higher on average. This year’s report also looks at employers’ experiences and views about mental health and substance use services, telemedicine, and wellness programs.

Publication Date: 27 Oct 2022

Publication Site: Kaiser Family Foundation

Brand-Name Drug Prices: The Key Driver of High Pharmaceutical Spending in the U.S.

Link:https://www.commonwealthfund.org/publications/2021/nov/brand-name-drug-prices-key-driver-high-pharmaceutical-spending-in-us

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High U.S. drug prices are a financial strain for patients, employers, and state and federal governments. In the following charts, we present the findings from a number of studies on prescription drug costs and spending in the United States with other high-income countries to reveal the main culprit: high U.S. prices for brand-name drugs.

The data for this chartpack come from the following sources: the Commonwealth Fund’s 2020 International Health Policy Survey; 1980–2020 pharmaceutical spending data from the Organisation for Economic Co-operation and Development (OECD); 2020 individual-level administrative claims or registry data compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC); and IQVIA’s MIDAS database for 33 OECD member countries for 2018.

Author(s): Aimee Cicchiello, Lovisa Gustafsson

Publication Date: 17 November 2021

Publication Site: The Commonwealth Fund

How Much Does a C-Section Cost? At One Hospital, Anywhere From $6,241 to $60,584.

Link: https://www.wsj.com/articles/how-much-does-a-c-section-cost-at-one-hospital-anywhere-from-6-241-to-60-584-11613051137

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When a woman gets a caesarean section at the gleaming new Van Ness location of Sutter Health’s California Pacific Medical Center, the price might be $6,241. Or $29,257. Or $38,264. It could even go as high as $60,584.

The rate the hospital charges depends on the insurance plan covering the birth. At the bottom end of the scale is a local health plan that serves largely Medicaid recipients. At the top are prices for women whose plans don’t have the San Francisco hospital in their insurers’ network.

The nation’s roughly 6,000 hospitals have begun to reveal the secret rates they negotiate with insurers for a range of procedures. The data offer the first full look inside the confidential deals that set healthcare rates for insurers and employers covering more than 175 million Americans. The submissions also illuminate how widely prices vary—even for the same procedure, performed in the same facility—depending on who is paying.

Author(s): Anna Wilde Mathews, Tom McGinty and Melanie Evans

Publication Date: 11 February 2021

Publication Site: Wall Street Journal