Foregoing Medical Treatment: A Dangerous Way to Cut Costs

(MoneyWatch)  "Self-medicating" is what many people do to avoid a doctor's visit or ride out an illness. It may entail downing ibuprofen for days to suppress abdominal pain or abusing alcohol to minimize the mental anguish of undiagnosed bipolar disorder.

A Consumer Reports study released today found another version of self-medication becoming more popular -- foregoing treatment altogether. The scope is alarming -- and should be a key concern remedied in the health-care reform legislation wrenching its way through Congress.

The poll of 1,022 adults found 51% rationed their own health care in the last year to keep medical costs down. Specifically:

• 28% cut back on doctor visits
• 22% put off a medical procedure
• 20% declined a medical test
• 20% didn't fill a prescription
• 15% used expired medication
• 15% skipped a scheduled dose
• 13% split pills
• 9% shared a prescription with someone else

So a few million people are avoiding doctor's visits and under-medicating themselves each day, what's the harm in that? Try much steeper bills in countless cases in the longer run.

Unlike preventative care, which aims to ward off future ills, foregoing or forestalling medical care does more than just postpone addressing problems - it often exacerbates them. As the condition of patients reluctant to seek treatment worsens, it generally requires more expensive medical intervention than would have been necessary earlier on.

This self-rationing has been one of the most unaddressed problems in the present health-care debate. Yet it's a critical one because it is occurring among people who actually have medical insurance, but can't afford to cover high-deductibles or co-payments.

Patient contributions serve a needed purpose in making individuals think twice about running willy-nilly to a doctor for the slightest malady. But when they're so steep that people at lower income levels put off necessary treatment, it just leads to far costlier bills once the mounting pain and suffering drive them to make the inevitable visit to a health-care provider.

Underutilization poses a financial strain on the health-care system just like the overutilization that reformers hope to curb, such as doctors ordering a phalanx of medical tests for liability concerns. What percentage of the 28% of people who cut back on doctor visits, or the 22% who put off a medical procedure, ending up saving or costing the system money is nigh impossible to gauge. But when 20% of patients don't fill a prescription - that's bound to catch up with them .

A medical system that discourages people from seeking early treatment before matters grow worse doesn't do any good for those patients -- or the rest of us contributing to the collective bill.