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Financial barriers causing millions to skimp on health care: study


Preventive visits, prescription refills are most likely to be delayed

stethoscope lying on cash ©


Nearly four in ten insured Americans (36%) skipped a health care visit within the last year for financial reasons, and that rate jumps to 83% for people without insurance, according to the results of a recent report from Payzen, a San Francisco-based health care technology company that provides payment plans.

The report, The High Cost of Health: Analyzing America’s Health Care Affordability Crisis, surveyed 1,007 Americans who had had a hospital visit or surgery within the last two years. Its results are consistent with those of a December 2023 presidential roundtable on the impact of medical debt.

The Payzen report found that the average American can afford a maximum of $97 for out-of-pocket health care expenses. When broken down by demographics, White respondents said they could go up to $104 while Black respondents topped out at $57 a month.

The most common forms of skipped care were preventative visits (49%), followed by prescription drug refills (48%) mental health care (40%) and diagnostic testing (39%) the report found.

To pay for health care, respondents said they would be willing to cancel vacations (91%), take on another part-time job (75%) or downsize their home (51%).

“It's not a willingness to pay issue, it’s a financial capacity to pay problem,” Itzik Cohen, founder and CEO of Payzen said in an accompanying news release. “These findings underscore the urgent need to address health care affordability issues to ensure equitable access to essential services and alleviate financial burdens on individuals and families.”

Since 2013, the average family health care premium has increased 47% and deductibles have increased 10%, KFF reports.

Among insured individuals, those with private insurance postponed care the most (49%), the Payzen report says. Medicaid enrollees came in second with 39% delaying care, followed by 33% of those with employee-sponsored plans and 26% with Medicare.

Increasing health care expenses touch many aspects of patients’ lives. The survey found that 61% of respondents are worried about paying utilities, 59% are concerned about paying rent and 59% are nervous about affording gasoline and food.

The health-related effects of delaying care are not small either. The Payzen report found that almost three-quarters of respondents (68%) reported increased stress about missing an appointment, 49% said the health problem they put off treating got worse as a result and 29% said they experienced negative effects on their job performance or career progression.

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