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Boomers and Gen Xers Skipping Health Care Due to Cost

Frightening implications from the new West Health Institute survey

By Richard Eisenberg

Between a third and a half of people age 45 to 59 and a quarter of those 60+ went without needed health care in the last year due to its cost, according to a troubling new survey from the West Health Institute and NORC at the University of Chicago.

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“We were surprised by the magnitude of the findings,” said Dr. Zia Agha, chief medical officer at the West Health Institute, a nonprofit applied medical research organization based in San Diego. “And 80 percent of the people we surveyed had health insurance, so just having insurance does not make you immune to health care costs.”

The researchers at West Health Institute and NORC at the University of Chicago (a nonpartisan research institution) interviewed 1,302 adults. Their findings were released Monday at the American Society on Aging’s 2018 Aging in America conference in San Francisco.

Age 45 to 59 Skipping Health Care

Specifically, the survey found these results for people age 45 to 59 (members of Generation X and boomers) as a result of health care costs:

  • 49 percent didn’t go to the doctor last year when they were sick or injured
  • 45 percent skipped a recommended medical test or treatment
  • 43 percent didn’t go to a dentist when they needed treatment
  • 40 percent went without a routine physical or other preventive health care
  • 30 percent didn’t fill a prescription or took less than the prescribed dose of medicine

Age 60+ Skipping Health Care

The percentages were less dramatic for people 60 + (boomers aged 60 to 72 and Americans older than 72) — perhaps partly because those 65 and older have Medicare. But they are still concerning:

  • 30 percent didn’t go to a dentist last year when they needed treatment
  • 27 percent went without a routine physical or other preventive health care
  • 25 percent didn’t fill a prescription or took less than the prescribed dose of medicine
  • 25 percent skipped a recommended medical test or treatment
  • 24 percent didn’t go to the doctor when they were sick or injured

Younger Americans were even more likely to go without health care due to costs last year, the survey found.

“The younger generations have lower savings, are less financially stable and are more likely to be not insured or underinsured,” said Agha. “As you get older, you understand the importance of health care more and you’re more likely to seek care.”

A Problem That Spans All Ages

But, Agha added, the survey's findings show that “this problem spans all ages. It’s not an old person problem or a young person problem.”

Given how much boomers and Gen Xers realize the importance of taking care of their health and their greater financial wherewithal to do so, it’s especially striking that so many are letting their health go.

But it’s also understandable, given ever-rising health care costs.

In Kaiser Health Foundation polls, since 2015, a growing percentage of the public has said they’ve had a difficult time affording medical costs. Last year, 37 percent reported having trouble affording health insurance premiums, up from 27 percent in 2015; 43 percent had trouble affording deductibles, up from 34 percent and 31 percent had trouble affording co-pays for doctor visits and prescription drugs, up from 24 percent.

And the West Health Institute survey found that most Americans don’t feel they’re getting a good value for their health care dollars.

The Danger for Older Americans' Health


Agha worries that forgoing medical appointments, treatments and prescriptions could lead to worsening health outcomes in the future.

“I can’t tell you what will happen to these particular 1,300 people. But as a physician I know that one of the largest problems we face is the burden of chronic diseases like hypertension and diabetes. For those, early detection and intervention is where medical science can help the most,” he said. By letting such diseases go untreated or undertreated, Agha added, “those problems become much more magnified and can lead to heart disease, kidney failure and a risk for getting a stroke.”

Overall, 53 percent of survey respondents say they had at least one of the following situations due to health care costs in the last year: they depleted their savings; they racked up credit card debt; they had to decide between paying medical bills and basic necessities or they couldn’t save any money.

Lack of Health Cost Transparency

The survey also found that, overall, 54 percent of Americans say they received a medical bill in the past year that they thought was covered by insurance and 53 percent got one where the amount they owed was higher than expected.

Speaking at the American Society on Aging's 2018 Aging in America conference Monday, Agha attributed those findings, in part, to a lack of price transparency and a lack of health care competition." He said: "Combine those two and most consumers don't have choices. We need to figure out how to let choices flourish."

In my interview with Agha before the conference, he explained: “As a health care consumer, you have very little information about the cost of care and the choices you should be making that will impact costs. The transparency issue is a huge problem in driving the cost of health care up.”

Health care prices are much easier to get and compare in many other countries, according to experts at the recent West Health Institute 2018 Healthcare Costs Innovation Summit in Washington, D.C., that Next Avenue reporter Holly Lawrence covered.

“There are prices on walls in doctors’ offices in France. In Australia, people are entitled to binding estimates before they go in for elective surgery,” Dr. Elisabeth Rosenthal, editor-in-chief of Kaiser Health News, said at that summit.

Views About Congress and Older Americans' Health

The West Health Institute and University of Chicago researchers also asked Americans whether they thought helping older adults access quality and affordable health care should be a priority for Congress. They did overall, overwhelmingly — 60 percent said it was extremely important or very important that their representative advance such policies.

But young people were far less likely to feel this way: only 36 percent of those age 18 to 29 favored prioritizing such care. Similarly, just 42 percent of them support increased spending on Medicare, compared with 62 percent of those 45 to 59 and 60 percent of those over 60.

Agha wasn’t especially concerned, or surprised, to see less interest by younger Americans in supporting health care for older Americans. “It’s only natural if you’re looking at something 30 or 40 years into your future,” he said.

Photograph of Richard Eisenberg
Richard Eisenberg is the former Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and former Managing Editor for the site. He is the author of "How to Avoid a Mid-Life Financial Crisis" and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Read More
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