BY MARTHA BEBINGER
WBUR, Jun 11, 2012
We’re hearing from a lot of different groups lately about what’s wrong with health care and how to fix it. But what do patients think? To find out, we asked Massachusetts residents who said they had a serious illness, medical condition, injury or disability requiring a lot of medical care, or spent at least one night in the hospital within the last year.
Our poll, Sick in Massachusetts, finds that 78 percent of patient respondents say the cost of care is a very serious or somewhat serious problem. And 63 percent say the problem has gotten worse over the last five years. (Click through the four charts below for some of the poll’s primary findings. The poll was conducted in partnership with the Harvard School of Public Health, the Blue Cross Blue Shield of Massachusetts Foundation and WBUR.)
We’ll bring you several angles on the findings. We begin with the stories of three patients.
Selected WBUR Poll Data Points:
On Health Care Costs In Massachusetts::
– 50% said health care costs are a very serious problem
– 28% said costs are a somewhat serious problem
– 15% said costs are not a problem
‘Major Reasons’ For Rising Health Care Costs:
– 86% said drug companies charging too much money
– 78% said insurance companies charging too much
– 73% said hospitals charging too much
On Quality Of Health Care In Massachusetts:
– 52% said the quality of health care is not a problem
– 37% said the quality of health care is a problem
– Those polled had a serious illness, medical condition, injury or disability requiring a lot of medical care, or spent at least one night in the hospital within the last year.
The ‘Oh My God’ Moment
Ask a patient about health care costs and they’ll often take you back to an eye-popping moment when they opened the envelope containing a hospital bill. Richard Marggraf, from Amesbury, remembers his “Oh my God” moment.
“Back in 1999, I was diagnosed with testicular cancer,” Marggraf said. “I went through quite a bit of therapy and procedures and what not, and those bills were in excess of $65,000 to $70,000, in 1999.”
Marggraf had a full-time job back then and generous coverage that paid virtually all of his bills. But now he’s working temp jobs and has coverage through the state with a $2,500 deductible. Marggraf can’t afford the CT scan his doctors recommend to make sure his cancer is still in remission.
“It’s a gamble, a little bit of a gamble,” he said. “Hopefully in the near future, when I gain full employment again, I can take care of that right away.”
Well, maybe. More and more employers are switching to plans with deductibles. Forty percent of the patients we polled say medical expenses they had to pay out of pocket last year are a serious problem.
Richard Marggraf can’t afford a CT scan to make sure his cancer is still in remission. (Martha Bebinger/WBUR)
Marggraf said he is more careful about where he goes for tests and procedures now that he is paying for more of the care.
“I have a lot of procedures done on the North Shore rather than going into Boston,” he said. “I think that tries to keep things down a little bit.”
But he’s frustrated by rising costs at his community hospital.
“The CEO that’s been there has increased prices dramatically at that hospital, and they’re profitable now,” Marggraf said. “At the expense of whom? At the expense of the consumer. I owe $1,000, I owe Worcester $500, I owe an ambulance $500.”
Rising Costs Leave Long-Term Bills
Mike Turcotte sat at his dining room table in rural Townsend, near the New Hampshire border, listing bills he must still pay for a one-week hospital stay last November. He’s on a payment plan and praying that he doesn’t have another serious illness anytime soon.
“If I have the same thing happen this year…” Turcotte said. He has insurance through his wife’s employer. Her share recently went up by $50 each week, a 60 percent increase.
Mike Turcotte is still paying off bills for his one-week hospital stay last November. (Martha Bebinger/WBUR)
“I wouldn’t have minded if I had the same insurance, but aside from that having to meet these deductibles,” he said.
Turcotte’s coverage also added a $2,000 deductible this year. He has Hepatitis C, high blood pressure and problems with his kidneys. He goes to the doctor a lot, takes seven medications every day, and is racking up even more bills.
“So do I, should I just stay home, ’til I really get deathly ill?” he asked.
Turcotte said he is grateful for all the money hospitals and insurers have spent on him already. He hopes to beat liver failure long enough to see his daughter graduate from high school.
“I’m so stubborn that I’ll probably be around for them to spend more money on me,” he said.
Turcotte said he doesn’t know who to blame for rising health care costs.
“I hate to say the government ought to do something, because that’s a mess,” he said. “But I would rather have the government take half of this amount and say, ‘OK, you’re covered for family.’ ”
‘I Couldn’t Keep The Home Plus The Medical Insurance’
“I’m a big girl, look at how I’m big. I can do it by myself now,” said tiny Giannie DeJesus, checking her blood sugar in her Disney princess nightgown. She was diagnosed with juvenile diabetes last year when she was just 2 years old.
“It was the worst day of my life, actually,” said Tracy DeJesus, Giannie’s mother. The diagnosis was scary and, DeJesus soon found out, expensive.
Tracy DeJesus and her daughter, Giannie, who was diagnosed with juvenile diabetes (Martha Bebinger/WBUR)
“When I checked out of the hospital, they told me to run down to CVS and pick up her medication,” she said. “It was $250.”
That was the first of many bills, even though DeJesus had health insurance through the dental office where she worked. DeJesus looked at her budget and the demands of monitoring Giannie’s blood sugar and made a calculated, but difficult, decision: She quit her job, left her apartment, and moved into a shelter in Chelsea.
“I realized that I couldn’t keep up the home plus the medical insurance,” DeJesus said. “I just can’t afford both. Pretty much we’re here because I couldn’t afford her insurance and I know I won’t be able to for years.”
Mother and daughter are now on MassHealth, the state’s Medicaid program.
“There’s like really no words, I’m speechless,” DeJesus said. “I’ve struggled, and I’ve tried. I’ve tried to look at every angle, what if I take this away, but this condition that she has, she has to have food, we just can’t take away from something else to give to the insurance.”
DeJesus has just started working part time at a mall. In the future, if she has the option, she’ll take less pay in return for a more generous insurance plan — one with no deductible, low co-payments and no tiered services.
“I really don’t think a medical insurance that I had the year before should even exist,” she said.