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WBUR Poll: Mass. Health Costs ‘A Serious Problem’ For Many

We’re hearing from a lot of different groups lately about what’s wrong with health care and how to fix it. But what do patients think? To find out, we asked Massachusetts residents who said they had a serious illness, medical condition, injury or disability requiring a lot of medical care, or spent at least one night in the hospital within the last year.

Our poll, Sick in Massachusetts, finds that 78 percent of patient respondents say the cost of care is a very serious or somewhat serious problem. And 63 percent say the problem has gotten worse over the last five years. (Click through the four charts below for some of the poll’s primary findings. The poll was conducted in partnership with the Harvard School of Public Health, the Blue Cross Blue Shield of Massachusetts Foundation and WBUR.)

We’ll bring you several angles on the findings. We begin with the stories of three patients.

The ‘Oh My God’ Moment

Ask a patient about health care costs and they’ll often take you back to an eye-popping moment when they opened the envelope containing a hospital bill. Richard Marggraf, from Amesbury, remembers his “Oh my God” moment.

“Back in 1999, I was diagnosed with testicular cancer,” Marggraf said. “I went through quite a bit of therapy and procedures and what not, and those bills were in excess of $65,000 to $70,000, in 1999.”

Marggraf had a full-time job back then and generous coverage that paid virtually all of his bills. But now he’s working temp jobs and has coverage through the state with a $2,500 deductible. Marggraf can’t afford the CT scan his doctors recommend to make sure his cancer is still in remission.

“It’s a gamble, a little bit of a gamble,” he said. “Hopefully in the near future, when I gain full employment again, I can take care of that right away.”

Well, maybe. More and more employers are switching to plans with deductibles. Forty percent of the patients we polled say medical expenses they had to pay out of pocket last year are a serious problem.

Richard Marggraf can’t afford a CT scan to make sure his cancer is still in remission. (Martha Bebinger/WBUR)

Richard Marggraf can’t afford a CT scan to make sure his cancer is still in remission. (Martha Bebinger/WBUR)

Marggraf said he is more careful about where he goes for tests and procedures now that he is paying for more of the care.

“I have a lot of procedures done on the North Shore rather than going into Boston,” he said. “I think that tries to keep things down a little bit.”

But he’s frustrated by rising costs at his community hospital.

“The CEO that’s been there has increased prices dramatically at that hospital, and they’re profitable now,” Marggraf said. “At the expense of whom? At the expense of the consumer. I owe $1,000, I owe Worcester $500, I owe an ambulance $500.”

Rising Costs Leave Long-Term Bills

Mike Turcotte sat at his dining room table in rural Townsend, near the New Hampshire border, listing bills he must still pay for a one-week hospital stay last November. He’s on a payment plan and praying that he doesn’t have another serious illness anytime soon.

“If I have the same thing happen this year…” Turcotte said. He has insurance through his wife’s employer. Her share recently went up by $50 each week, a 60 percent increase.

Mike Turcotte is still paying off bills for his one-week hospital stay last November. (Martha Bebinger/WBUR)

Mike Turcotte is still paying off bills for his one-week hospital stay last November. (Martha Bebinger/WBUR)

“I wouldn’t have minded if I had the same insurance, but aside from that having to meet these deductibles,” he said.

Turcotte’s coverage also added a $2,000 deductible this year. He has Hepatitis C, high blood pressure and problems with his kidneys. He goes to the doctor a lot, takes seven medications every day, and is racking up even more bills.

“So do I, should I just stay home, ’til I really get deathly ill?” he asked.

Turcotte said he is grateful for all the money hospitals and insurers have spent on him already. He hopes to beat liver failure long enough to see his daughter graduate from high school.

“I’m so stubborn that I’ll probably be around for them to spend more money on me,” he said.

Turcotte said he doesn’t know who to blame for rising health care costs.

“I hate to say the government ought to do something, because that’s a mess,” he said. “But I would rather have the government take half of this amount and say, ‘OK, you’re covered for family.’ ”

‘I Couldn’t Keep The Home Plus The Medical Insurance’

“I’m a big girl, look at how I’m big. I can do it by myself now,” said tiny Giannie DeJesus, checking her blood sugar in her Disney princess nightgown. She was diagnosed with juvenile diabetes last year when she was just 2 years old.

“It was the worst day of my life, actually,” said Tracy DeJesus, Giannie’s mother. The diagnosis was scary and, DeJesus soon found out, expensive.

Tracy DeJesus and her daughter, Giannie, who was diagnosed with juvenile diabetes (Martha Bebinger/WBUR)

Tracy DeJesus and her daughter, Giannie, who was diagnosed with juvenile diabetes (Martha Bebinger/WBUR)

“When I checked out of the hospital, they told me to run down to CVS and pick up her medication,” she said. “It was $250.”

That was the first of many bills, even though DeJesus had health insurance through the dental office where she worked. DeJesus looked at her budget and the demands of monitoring Giannie’s blood sugar and made a calculated, but difficult, decision: She quit her job, left her apartment, and moved into a shelter in Chelsea.

“I realized that I couldn’t keep up the home plus the medical insurance,” DeJesus said. “I just can’t afford both. Pretty much we’re here because I couldn’t afford her insurance and I know I won’t be able to for years.”

Mother and daughter are now on MassHealth, the state’s Medicaid program.

“There’s like really no words, I’m speechless,” DeJesus said. “I’ve struggled, and I’ve tried. I’ve tried to look at every angle, what if I take this away, but this condition that she has, she has to have food, we just can’t take away from something else to give to the insurance.”

DeJesus has just started working part time at a mall. In the future, if she has the option, she’ll take less pay in return for a more generous insurance plan — one with no deductible, low co-payments and no tiered services.

“I really don’t think a medical insurance that I had the year before should even exist,” she said.

Here’s the poll (and you can see more detailed poll results here):

http://www.scribd.com/doc/96682782/Sick-in-Massachusetts

The Blue Cross Blue Shield of Massachusetts Foundation, the Harvard School of Public Health (HSPH) and WBUR worked in partnership to produce Sick in Massachusetts. The Foundation commissioned and funded the HSPH poll. An independent research firm, SSRS, conducted the telephone interviews and provided WBUR with the names of poll participants. WBUR met with the partners to review the poll questions and analyze the results. WBUR shared story scripts with Robert Blendon at HSPH for fact checking purposes. WBUR, using internal editing procedures, decided how to frame and expand on issues raised by the poll results.

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  • Dave Seaman

    these individual stories are very moving. I felt I’d be remiss tl remain silent of my own challenges in the wake of Romney’s Health Care Travesty and the now under scrutiny “ObamaCare.” For twenty-two years I was a teacher. In Massachusetts we paid into the Mass teachers Retirement Fund. My wife worked as the secretary to the Superintedent of schools at one of Massachusetts largest cities. We got our health insurance through her work: Blue Cross of Massachusetts, Network Blue, an HMO program. In 2005 I was struck with a severe and rare illness called Guillain-Barre Syndrome. The disease renderred me an invalid. My wife and I were eivorced and wheree I continue to have my insurance through Blue Cross of Massachusetts, my disability pension from the MTRS is just shy of fifteen thousand dollars a year: I cannot afford to be an invalid in the state where I lived and serverd for three decades. In 1999 I was a finalist for Massachusetts Teacher of the year; I’ve been named to “Who’s Who in Americas Teachers” EIGHT times and I averaged a 70 hour week, utilizing my summers to continue my education and to do research to make me a better teacher. Blue Cross of MA will nto cover me outside of the Commonwelath o9f Massachusetts , yet my low disability and my medicalk expenses (in -state my co-pays equalled 42% of my stipend. I moved into a homeless sehtlerr but I really required (require) full time care. I’ve been forcved, as a homeless invalid, to leave Massachusetts, at least for a while, and in exchange I must now go without health insurance, though Blue Cross continues to be paid over a thousand dollars a month for our family insurance.
    GThere is no question that I am sloiwly easing my way to death. I have never been ignorant to the difficulties of humanity, but all of those years, paying into IRA’sw, 5239A College Funds (all of which went down the drain on october 3, 2008) but we do have the right to happiness, merely the pursuit of happiness. I am lucky that I had a career that was a part of my soul. But I should be allowed to die with dignity and for seven and a half years I’ve spent the small amount of energy I’ve left in attempting to get understanding and heolp from a severely exchausted system. The fence that

    george b’ush built between Mexdico and the United ststaes could allow me to be bathed each day, put into clean clothing, fed at regular intervals and medication giuven to me at appropriate intervals. A small amount of dignity is something that belomngs on the list with :Lifem Liberty and the pursuit of happoiness.
    but ours is a culture that is quickly forgetting about respect and dignity.

    For those who are friswtrated with the typos, it is a result of the dammage done to my hands from the neuromuscular disease thaty changed my life.

    Again, my disability income comes entirely from my private pension as a teacher in service to the Commonwealth. I stress this because of those who have spit upon me calling me a welfare slob.

    • Henry Vere

       I have tears in my eyes reading your story, Dave.  If you’d ever like to talk just contact me at: evereader@msn.com thanks!

    • Jane

       My goodness Dave. I can’t tell you how moving your story is. I only wish I knew the answers. I am Canadian and these kind of stories just do not happen in Canada. We have our own health care issues here but your story is an indictment to the US health care system.

  • Jasoturner

    It seems inevitable that access to care will be proportional to one’s ability to pay for it, at least here in the U.S., where the philosophy of the marketplace is king.  It also seems to me that today’s reasonably well insured middle class workers will be squeezed out of many premium care diagnostics and treatments in the future.

    Of course, when folks like me can’t afford an MRI, the cost of MRIs will increase dramatically.  But I am personally acquainted with several people for whom $50,000 out of pocket for premium healthcare would not be an issue.  Even on an annual basis.

    Will America in the future have an elite class that can afford higher education and premium health care, while the majority get by as best they can, praying that a simple twist of fate does not wipe out the assets they and their families have accrued over the years? 

    O brave new world, that has such people in it!

    • Dave Seaman

      You write with c,.arity and intelligence. My only thought- and my only reason for sconsistently commenting here, is that our country DOES exist based on “We The People.” We have the power to make change. Look at the change in our first ammendment- the internet did more for that than anything ever.
      No one ever said we are entitled to good health;  social services; to quality education; all we have been promised was freedom. We are free to do a great deal, those these freedoms drift away a lot. We are free to die. We are free to go hungry. We are free to lie in a ditch homless and untreated when savaged by a rare illness. Not only do I have top of the line insurance but because I was ravaged by a rare neoruomuscular illness I am eligible for medicare. However my pension pays me $15000 a year, ten percent of my old income. I cannjot afford toi live in Massachusetts any longer and my health insurance- which remains current at a cost of $1000 a month, will not cover me outswide of Massachusetts.
      Curioser and curioser.
      Too many people with unclear priorities; too many people who hate; too many who complain but will not pick up a legitimate pen and write, via post, their representatives.

  • X-Ray

    “Mass. Health Costs ‘A Serious Problem’ For Many”

    Really? We in Mass. are taught that the mandated
    universal health care is the solution for all health care problems. Everyone is
    covered, the costs go down and the quality is improved. You mean the one-sided
    political machine lied to us and the program they have formulated doesn’t
    delivery the promised benefits?

  • The Rest is Silence

    Atul Gawande’s excellent article about the problems with our health care system a few years back, in the NYer gave us some excellent suggestions for finding our way out of this mess. As far as I’m concerned until we admit the truth – that our health is NOT something any of us trust or desire a free market solution for – we will continue to have these gut-wrenchingly painful to be frank, ridiculous stories.  This is mainly because they don’t have to be.  When someone is having a heart attack they don’t ask for directions for the ER with the lowest rates….but basically that’s what our system has moved toward.  How dare they think that we want to shop around when it comes to our health.  We all want the absolute best for ourselves, our families and our neighbors – PERIOD end of discussion, no negotiation there.  Gawande’s article showed places, Rochester MN & Grand Junction CO etc. where better plans are working for the community.  We the People need to stand up for ourselves.  These are our bodies, our minds and those of our families.  Government and the health care it can supply can work.  Medicaid is a fantastic program mainly because there are no insurance companies getting involved.  It’s gonna take work but there is a way out of this mess – and it is a mess absolutely.  We have the incredible technology to extend and enhance life but place a moral code that is like something out of feudal times  – no in feudal times even the masters were kinder to the serfs than modern-day bill collectors are – over this technologically amazing creation in our midst. So sad.  Let’s do something about it!

    • Johnspek

      Some corrections to this post

      Medicaid actually is managed in many areas by private insurersMedicaid, and Medicare also cost taxpayers over 12,000.00 per person, per yearBoth Medicare and Medicaid are refused by almost 50% of Doctors and Clinics
      There are even ER’s in the country closing rather than accept the Medicaid client

  • Kalm30

    We need to keep the insurance companies out of our health! In Ma, we were promised lower premiums, instead they keep going up and up!

    • Johnspek

      Perhaps they will go lower with the “new” health law and all of the “new” extras that have to be covered

    • Dave Seaman

      I think that you should write the Massachusetts Insurance Commission to voice your thoughts. Insurance companies do employ doctyors and nurses but these people’s job descriptions do not involve the patients best iknterests. We have a contract with out provider and anything beyond that, we can jusyt die in a ditch.
      The world is overpopulated as it is. (forgive the sarcasm)

  • Ellie Cutler

    I am 60 yrs old and on disability.   The first two years of my disability I was on Commonwealth Care.  My social security check is too much to be on Mass Health.   After two years on ssdi, I automaticallly qualify for medicare, which means that CC will bump me off – no choice in the matter. But to get the same coverage as I had on CC, it will cost me roughly $400/moth- which is one third of my income!  CC was about $100.   

    The middle class on social security is going to be bankrupt by health care costs.  If I was poor I would be on medicaid like my mother-in-law who has EVERYTHING covered for free – not even a deductible, and that includes dental!   PLEASE LET MEDICARE-ELIGIBLE PEOPLE STAY WITH COMMONWEALTH CARE!!

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