Americans skipped recommended medical tests and procedures, cut pills, and skipped dental care due to cost in the past year.

Welcome to the world of rationing, borne not from a government program, but of private sector market forces.

With all due respect to Adam Smith, market forces don’t always work in the best interests of public health.

The latest iteration of Kaiser Family Foundation‘s Health Tracking Poll published February 25, 2009, found that 53% of Americans did at least one self-rationing health behavior because of cost in the past year (roughly February 2008 to February 2009).

The most common health behavior driven by cost concerns is using home remedies and over-the-counter drugs as a substitute for going to the doctor, reported by 1 in 3 people. 1 in 3 also skip dental care or checkups.

1 in 4 Americans put off needed visits to postpone necessary care, as well as skip prescribed tests or procedures.

1 in 5 Americans don’t fill prescription drugs that doctors recommend, and 15% of Americans split pills to conserve the meds for future use. Finally, mental health gets short-shrift when it comes to cost, as 7% of Americans

Health Populi’s Hot Points: Most Americans are worried about health care costs; 45% told KFF they are “very” worried to pay more for care and insurance — the highest percentage Kaiser has found since 2006.

Most Americans well-understand that health insurance coverage is tied to employment: 56% are very worried about affording health care they need when they believe someone in their household will lose a job this year.

And the covered worker is also worried: 34% of people with health insurance are worried they will lose coverage.
Last night, President Obama kicked off his first speech to Congress with the words,

“I know that for many Americans watching right now, the state of our economy is a concern that rises above all others….You don’t need to hear another list of statistics to know that our economy is in crisis, because you live it every day. It’s the worry you wake up with and the source of sleepless nights….The impact of this recession is real, and it is everywhere.”
The recession is driving health rationing among Americans. The personal short-term fiscal choices like pill-splitting and foregoing preventive tests due to copays and coinsurance will inevitably lead to longer-term physical consequences.