Sick Mass. Residents Say Health Care Costs Are a Worsening Problem

BOSTON — Although Massachusetts has nearly universal health insurance coverage, high costs pose a serious financial problem for the segment of the population most in need of health care, and these residents say the health care cost situation in the state has gotten worse. They have a much more positive attitude toward the quality of health care in Massachusetts, however, and most say quality has improved or stayed the same over the past five years.

These are among the findings of a statewide survey conducted by researchers at the Harvard School of Public Health in partnership with WBUR, the Blue Cross Blue Shield of Massachusetts Foundation, and the Robert Wood Johnson Foundation. The survey focuses on sick adults — ones who said they had a serious illness, medical condition, injury, or disability requiring a lot of medical care, or who had been hospitalized overnight in the past 12 months.

The president of the Blue Cross Blue Shield of Massachusetts Foundation, Sarah Iselin, said the survey adds a key perspective to the debate on how to tame health care costs in Massachusetts — that of people who need a substantial amount of health care services. “What sick people are telling us is that, even though they have access to needed care, many are not adequately protected against financial hardship,” she said. “That’s why it’s so important to make sure we address the root causes of rising costs and not just continue to shift the burden to patients through higher deductibles and co-pays.”

Sixty-three percent of sick adults said the problem of health care costs has gotten worse in Massachusetts over the past five years. More than one-third of sick adults (36{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) reported that the cost of their medical care over the past 12 months caused a serious problem for their family’s financial situation. One in seven sick adults (14{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) said there was a time in the past 12 months when they could not get medical care they needed, and those who could not get care mainly cited financial reasons. One in 12 (8{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) reported being refused care by a doctor or hospital for financial or insurance reasons at some time during the past 12 months. Forty percent say their out-of-pocket costs for medical care are a serious problem for them.

The survey told a different story about quality, however. About half of sick adults (48{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}) said they are “very satisfied” with the medical care they received over the past 12 months, while 36{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of sick adults are “somewhat satisfied” but think “some things could have been better.” Three-fourths of respondents said that, overall, quality of care in Massachusetts had improved or stayed the same during the past five years.

Robert Blendon, professor at the Harvard School of Public Health and director of the survey, said that, while sick residents have a generally positive view of health care quality and value in Massachusetts, they are sending a clear message about the need to improve coordination of care. “People who have real-life experience with the state’s health care system report problems that occur when their care is not well-managed or when there’s a lack of communication among those caring for them,” Blendon said. “The fact that they see these problems supports the efforts of the many physicians and hospitals that are working to improve the situation.”