Economic Woes Undermine Health Care

More Americans are skimping on medical care because of money troubles, the Associated Press reported October 23. A new poll from the Kaiser Family Foundation showed the trend. People were asked if they have put off medical care or tests. More people said yes than a similar poll showed in April. Fewer prescriptions are being filled, too. The drop occurred in the quarter that ended in June. IMS Health, which collected the data, said it was the first drop ever.

What is the doctor's reaction?

It's always uncomfortable when patients tell me they stopped taking one or two medicines because they had to pay for rent and food. But at least these patients did make and keep their appointments.

I have been fortunate to practice in settings where almost every patient has had some health insurance. But today co-pays and out-of-pocket expenses are rising even as the economy is turning down. In this climate, even those with insurance will feel some pressure to skip appointments. This is most likely to affect visits for routine screening, prevention and checking on conditions such as high blood pressure and diabetes.

What changes can I make now?

No matter what the economy, you can always reduce your medical costs by choosing a healthy lifestyle. For people who need to seek private insurance, this could save thousands of dollars on your policy. These two choices will make the most difference:

• Don't smoke or use any other tobacco products.

• Keep your weight as close to the normal range as possible.

Do you have a long-term (chronic) condition, such as high blood pressure or diabetes? A better diet and more exercise may quickly allow you to take less medicine.

High blood pressure—To help lower your blood pressure with less medicine:

• Eat plenty of fruits and vegetables. Reduce your salt intake. This is the DASH diet.

• Reduce your weight, if needed. Sometimes even as little as 10 pounds of weight loss can dramatically lower blood pressure.

• Exercise regularly. If you need to lose weight, aim for 60 minutes per day. All of us should get at least 30 minutes of moderate-intensity exercise daily.

• It's not easy during these times, but try stress-reducing techniques. Take short breaks, for five to 10 minutes, several times during the day. Just sit comfortably in a chair, close your eyes and do relaxation breathing.

• Keep alcohol consumption in check. Men should have no more than two drinks per day. For women, no more than one a day is best.

Diabetes—You can reduce your pharmacy bill and your risk of further health problems from the disease. The key is to follow a healthy diet, keep weight under control and exercise regularly.

Here are some other ways to help save money on medicines:

• Review your list of medicines with your doctor. See if any can be eliminated or at least have the dose reduced. This is always a good thing to do, even in a better economy.

• Ask if any of your medicines can be changed to a generic.

• Discuss whether some of your medicines can be split. It may save you some money to have your doctor prescribe a higher dose that you split in two.

What can I expect looking to the future?

Economic downturns like the one we are facing now are always challenging. However, they can provide a strong motive to take action on those lifestyle choices that are free. Many of them, such as quitting smoking, will save you money right away.