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Bracing for the Economic Consequences of a Chronic Health Condition

This is a staggering statistic…

60% of Americans live with at least one chronic condition, such as heart disease, cancer, or diabetes. By definition, a person who suffers from a disease for at least a year and requires ongoing treatment or can have limited activities, or both, is considered to have a chronic condition. While an estimated $3.8 trillion are spent annually on healthcare, chronic families get stuck with medical bills, despite having insurance.

This is the first in a series of articles from Patients Rising touching on finances in chronic illness families. We will provide appropriate resources wherever possible.

Chronic Health Conditions Can Raise a Family’s Medical Debt

High out-of-pocket (OOP) costs may be the primary reason for the financial pinch that patients and their families may face. However, debilitating chronic conditions (cancer, depression, diabetes, among others) may compromise a person’s ability to work, leading to wage loss. Additionally, a family caregiver may need extended time off from work, further affecting the family’s income.

When researchers reviewed the relationship between the number of chronic conditions and its impact on a family’s medical debt, here’s what they found. Of the nearly 6,000 households in the analysis, 73% had OOP costs and 9% had medical debt. Families with 1-3 or >4 chronic conditions were more likely to face household medical debt. The study found a direct correlation between the number of chronic conditions and the amount of medical debt:

  • No chronic conditions: $359.48
  • 1-3 chronic conditions: $1,267.06
  • >4 chronic conditions: $2,986.68
Findings from “The burden of out of pocket costs and medical debt faced by households with chronic health conditions in the United States

Finances in Chronic Diseases

In 2016 the Partnership to Fight Chronic Disease stated 49% of the U.S. workforce (primarily ages 45-64) suffers from at least one chronic condition. This burden on actively working adults can result in lost wages. Diabetes and arthritis alone, two of the most common chronic diseases, are responsible for $116 billion in lost wages and other financial losses annually. This loss is over and above medical expenses. 

When the Kaiser Family Foundation analyzed data from the Survey of Income and Program Participation to understand demographic factors that influence medical debt, household income, insurance status, and complex medical needs stood out:

  • 12% of adults with incomes below federal poverty level* had significant medical debt
  • 13% of adults who were uninsured for more than six months of a year were more likely to report significant medical debt
  • 21% of adults with poor health had medical debt
  • 15% of adults with disability had medical debt

*Federal poverty level in 2019: $12,490 (single person income)/$25,750 (family of four)

Cancer and Medical Debt

A cancer diagnosis can impose significant “financial toxicity” on a family, with high out-of-pocket costs and medical debt. The impact is even greater if the person diagnosed is the head of the household or a spouse. Such cases may lead to loss of employment and insurance benefits.

Cancer patients and their families spent over $21 billion dollars in 2019 alone on cancer care.

  • $16.22 billion on out-of-pocket costs
  • $4.87 billion on getting to and from medical appointments, waiting for treatment, and receiving treatment

A recent report from the American Cancer Society Cancer Action Network highlights long-term medical debt among cancer patients and survivors. Of the 1,218 cancer patients and survivors who participated in the survey, 51% reported incurring cancer-related medical debt between $5,000-$10,000. Among these:

  • 53% had their debt go into collection
  • 46% saw the debt affect their credit

These are significant cost burdens that may be unavoidable. However, there could be ways to reduce this economic impact, as this article explains

Breaking News! The top three credit reporting agencies in the U.S. (Equifax, Experian, and TransUnion) recently announced that they will be dropping most medical debt from consumers’ credit reports.

– CBSNews.com, March 18, 2022

Where Can I Look for Financial Support for My Cancer Treatment?

Other articles on finances in chronic illness

Surabhi Dangi Garamella

Surabhi Dangi-Garimella, Ph.D. is a biologist with academic research experience, who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.

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