Health and Science

Health-care crunch: Patient costs rise, ability to pay drops

If you've been feeling a bit more financially strapped when faced with medical bills, you're not alone—not by a long shot.

Americans last year were hit both with "skyrocketing" costs for some popular medical procedures, and with health insurance deductibles that are rising at a rate well above inflation.

Carmen MartA-nez BanAs | Getty Images

At the same time, the amount of revolving credit that people can tap to help pay some leading health-care costs decreased, according to a study released Wednesday by TransUnion Healthcare, a subsidiary of the large credit-report company. And if you have a low credit rating, that problem has gotten even worse.

"Consumers continue to feel the pressure of rising health-care costs," said Gerry McCarthy, president of TransUnion Healthcare. "Despite a slowly improving economy, many consumers are finding they have less money to make these payments."

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The TransUnion report, which analyzed data from about 400,000 providers, underscores the fact that even as overall health-care costs have been rising at a much-lower rate in recent years, actual consumers of medical services are directly shouldering a bigger share of the bill.

In a column earlier this month in The Wall Street Journal, Kaiser Family Foundation President Drew Altman wrote, "The rate of increase in health spending and premiums in recent years is about as low as I have ever seen it."

"But for most people the pain from health-care costs is more intense, because the divide between out-of-pocket health costs and individuals' wage growth has widened," Altman wrote.

Adding to that pain in 2014 was an 11 percent jump in average patient costs—what they personally paid—from $2,245 in late 2013 to $2,491, according to TransUnion. "The increase is primarily attributable to skyrocketing costs for popular joint-replacement procedures, which rose nearly 20 percent," TransUnion said. The out-of-pocket costs for those procedures grew from an average of $2,535 to $3,135.

McCarthy pointed out that even without normal inflation in the cost of medical procedures, consumers would likely be feeling more of a pinch when it comes to footing the bill.

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The average deductible—which is what people have to pay out of pocket before their insurance covers the cost of medical treatment—grew by 7 percent last year, TransUnion found. At the end of 2013, the average consumer had a deductible of $1,062, but that had risen to $1,133 by the end of last year.

And, McCarthy said, "Deductibles have nearly doubled over the past five years through the adoption of high-deductible plans offered by employers and the implementation of the Affordable Care Act."

ACA individual plans sold on government-run Obamacare exchanges often have higher deductibles than employer-provided insurance plans.

"We suspect that average deductibles could rise much more in the coming years," McCarthy said.

In his Wall Street Journal column, Altman of the Kaiser Family Foundation wrote, "Since 2006 wages have grown 23 percent while deductibles for single coverage have risen 108 percent."

TransUnion's report also found that consumers' ability to pay for three common medical procedures—joint replacement, natural birth and C-section deliveries—decreased by 11 percent, according to a metric known as the TransUnion Healthcare Cost Ratio.

That ratio measures the amount of total revolving credit lines available to consumers relative to every $100 in out-of-pocket costs for those select health-care procedures. Revolving credit includes bank-issued and store credit cards as well as home equity loans.

In 2014, the average consumer's total revolving credit line fell from $34,111 to $33,676. That meant that the Healthcare Cost Ratio dropped from 15.5 to 13.5, for average consumers.

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For subprime consumers, who have less access to credit, the ratio fell more sharply from 4.4 to 3.6, according to TransUnion. The average subprime customer has access to only slightly more than $9,000 in revolving credit.

A TransUnion survey of insured consumers in 2014 found that 54 percent of them were either sometimes or always confused by the health-care bills they received. Another 62 percent said they were either sometimes or always confused by the out-of-pocket costs they were required to pay.

That earlier survey, which questioned 7,407 people, also found that only about 25 percent of consumers reported receiving pretreatment cost and insurance coverage estimates that they would consider helpful in managing their medical expenses.