One in Four Women Delay Medical Treatment Because of Cost, Study Says

Jul. 8–Cheryl Hart feels like somebody is driving a spear through her head. Her infected left ear is oozing fluid and so swollen she can barely hear on that side. It’s been like this for three weeks.

So far, none of the remedies she’s tried have cured it. Not the peroxide she poured in her ear. Not the two different prescription antibiotics she took from concerned girlfriends. And not the prescription painkillers provided by her daughter.

The one cure she hasn’t tried is a doctor.

“I can’t go. I can’t pay the bill,” said Hart, an unemployed single mother of three.

One in four American women delay or don’t get needed medical treatment because they can’t afford it, according to a study released Thursday by the Kaiser Family Foundation. Though the poor and uninsured are far more likely than others to skip filling prescriptions or miss physician visits, cost worries constrict care for women from all walks of life.

“A sizable share of women are falling through the cracks, either because they don’t have insurance or even with insurance can’t afford to pay for medical care or prescription drugs,” said study author Alina Salganicoff, director of women’s health policy for the Kaiser foundation, a nonprofit research group with no ties to the health plan Kaiser Permanente.

Men have price problems, too. But Salganicoff said this study singled out one gender because women live longer, use more health care services over the course of their lives and have unique medical needs often overlooked in studies of both sexes.

In a telephone survey of 2,766 women nationwide, the study found:

–38 percent of women have chronic conditions that require ongoing medical attention, compared to 30 percent of men.

–At least one in four women who need mammograms, breast exams and cervical cancer screenings have not had these tests in the past two years.

–One in three women with health problems didn’t fill prescriptions due to cost. One in four spent $100 or more each month on drugs, and one in 10 women paid at least $200 a month.

Hart has insurance though Medi-Cal, a government health program for the poor. There are no monthly premiums. Although some people qualify for free coverage through Medi-Cal, Hart said she can’t afford it because the state requires her to spend $1,008 a month before coverage kicks in.

“It’s worse than being uninsured,” Hart said, perched on a worn sofa in her Fair Oaks rental home and sifting through the stacks of papers she’s amassed in attempts to get affordable health care.

Medi-Cal is charging her money because the state believes Hart, 38, collects a $1,941 monthly disability check for a hand injury that forced her to leave work, according copies of Medi-Cal letters she shared with The Bee.

Hart also has a May 5 letter from the state explaining that her disability payment was stopped because she did not see an orthopedic surgeon in time to meet a government deadline for demonstrating continued need for benefits. She places blame on the surgeon, who she said twice missed her scheduled appointments.

Hart is appealing to the state Employment Development Department to get her disability payments resumed. She also plans to appeal the Medi-Cal decision to charge her for care but has not yet figured out how to do so.

Medi-Cal spokeswoman Norma Arceo said Hart has not notified officials at the health program about the disability payments ending. Arceo also said Hart could see a doctor without paying up front and be billed later for any share of the tab she might owe.

“The bottom line is she needs to get treatment. She needs to communicate with us so we can help her,” Arceo said. “We can resolve any share-of-cost issue after she sees a doctor.”

Meanwhile, Hart is running out of ways to self-medicate her ear infection.

The first antibiotics she borrowed from a friend gave her stomach cramps and made her vomit. So she stopped taking those pills and dipped into a different bottle of medicine from another friend. This time, she realized after the first dose that she had swallowed a drug that sent her to the hospital once before with a severe allergic reaction.

Like most patients, Hart knows it’s dangerous medicine to take drugs not prescribed for her.

“You have no idea how desperate I am for relief,” Hart said. “I am in so much pain all the time. I get up in the morning and I call and call to fix this mess the government has put me in. I get pushed around and nobody helps, and I don’t have any money to do anything about it.”

Top-drawer medical coverage hasn’t kept Karen Darr from fretting over costs. She works for the Small Business Administration in Sacramento and gets insurance through the Federal Employees Health Benefits Plan.

Darr has plenty of flexibility to leave work for medical appointments, plus a generous bank of paid sick days. What she doesn’t have is money to pay for weekly allergy shots.

Until this year, she paid nothing for the shots. In January, her health plan instituted a $30 fee per shot.

“I stopped getting them,” Darr said. “I’m trying to make do with some of the various allergy pills at the drugstore. It’s not as good, but it’s better than nothing.”

An elderly mother has Kathleen Davis worried about health costs. Davis drives to Sacramento every Saturday from her Amador County home to look in on her mom, who is 89.

Recently, she discovered her mother had a urinary tract infection that had been raging, untreated, for nearly two weeks.

“She has Medicare, but she still has to pay part of the bill herself,” Davis said. “She is a widow with almost no income, and she didn’t tell me about the infection because she was afraid of how much it would cost to treat it.”

If the cost of medicine doesn’t deter women, then other issues — lack of child care, transportation or time off from work — often do.

Renee Roberts is a biology major at California State University, Sacramento who has a part-time job and no health insurance.

Before her husband passed away last July, she was out of the work force for nine years caring for him as diabetes and then renal failure savaged his system.

Now 41 with a history of suspicious breast lumps, Roberts needs a mammogram. She knows there is a state program that will cover the cost, but she has not had time to get the referrals and paperwork for the exam.

With insurance, Roberts imagines making a single phone call to her personal physician to schedule her annual mammogram. And she expects she would get it on time every year.

She wishes she — and everyone — could afford insurance.

“What should be more important in our society than the health of our citizens?” Roberts asks. “We are not asking for top of the line or anything, just something to take care of us so we can take care of our families and be productive in society.”

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