What good is health care you can't get? Ask Katie Larson. She's 30, a resident of Lake George, Minn., and the office manager at Coldwell Banker Clack & Dennis Real Estate in Park Rapids.
"I avoid using the doctor any time I can," she said. "I think the last time I used the doctor was three years ago."
The reason, she said, is "I’m terrified that it’s going to bankrupt me. So, if I can avoid going to the doctor because I don’t have a broken leg, then I won’t."
Larson isn't alone in her struggle with rising health care costs. The cost of care continues to highlight the lack of market controls for nearly 20% of the U.S. economy.
According to a report issued recently, outpatient services costs grew 7.4% in Minnesota, over three times as much as the 2.4% rise for inpatient services. Minnesotans spent 9.6% more on services in 2018, nearly a double-digit price hike for a trip to the doctor. It comes on top of a 9.1% price jump in 2017.
Numerous Minnesotans we spoke to had horror stories to share about the rising cost of health care, insurance and avoiding treatment for health issues to save money.
'I definitely wouldn't have gotten that MRI'
Tyler Behrns, 24, works full time in marketing and lives at home with his mother in Dodge Center, Minn. Because he is under 26, he is covered under his mother's employer plan through Medica.
In September, when a five year old shoulder injury started to cause back strain he went to his general practitioner, who referred him to a specialist. After a 15-minute consult the specialist referred him for an MRI of his shoulder and neck.
"I wasn't aware of the deductible until I got the post-declaration sheet, and my mom obviously was not either. I asked her before I went in if there was going to be a big charge for the MRI and she said I'm not sure where we're at with the deductible."
They told him he had a torn labrum, but they couldn't do anything to fix it. He just need physical therapy. A week later the bill came. The first MRI was $1,700 and the second maxed out the $2,000 left on the family deductible.
"So now I owe Mayo Clinic $2,000 for two MRIs," he says with a look of sober resignation. "I thought insurance would cover more of it." he made arrangements with the Clinic and now he pays them $200 every month.
How does the $200 monthly bill affect Behrns? Now he lives with his mom, as he tries to save for his own place. Student loans take 35% of his paycheck. The payment cuts into his money for food, gas, going out and savings.
"If I had known that was going to be the case," he says about the deductible, "I definitely wouldn't have gotten the MRI."
'It's been a godsend'
Medical bills are involved in many bankruptcies, studies how shown. A study featured earlier this year in the American Journal of Public Health found that more than two-thirds of bankruptcy debtors — 67.5% — cited medical bills as a contributing reason for their bankruptcy.
Also earlier this year, the personal finance website Bankrate found that only 40% of Americans have sufficient savings to cover a $1,000 emergency expense.
That figure actually had risen from 65.5% before passage of the Affordable Care Act in 2010, according to the study in the American Journal of Public Health.
Lois Bjorklund of Alexandria said she has not found employment with health insurance since getting laid off from Tastefully Simple five years ago. She relies on MinnesotaCare, she said.
"It's been a godsend," she said, adding, "It's a lot of paperwork and red tape." As a part-time retail worker, her hours fluctuate seasonally, so she has to call the state and let them know when her hours are expected to change. The state adjusts her copays accordingly.
Before her layoff, Bjorklund said, she didn't understand the struggle many face for affordable health insurance.
"I've gotten better insight into what other people go through," she said.
'He couldn't stand the pain anymore'
Insurance is increasingly unable to do its job — to protect consumers from the financial harm of seeking health care.
In lieu of raising premiums, insurers are increasingly passing along these higher prices in the form of higher deductibles and copays. For the first time ever, more employers are offering high-deductible plans than not, making cost-shifting the dominant form of insurance coverage, even for those with supposedly good benefits.
Thanks to budget-straining deductibles in which employees with family plans are billed anywhere from the first $4,000 up to $9,000 a year before gaining a service that's not preventive medicine, employees with coverage now pay 27% of their health care out-of-pocket.
Clarice Platz, 60, of rural Park Rapids is a sales associate at Kathryn’s on Main and is insured through her husband’s employer.
Platz estimated that their out-of-pocket health expenses have increased 10-15% during the last four or five years.
"My husband got hurt and didn’t want to go for about three days, until he couldn’t stand the pain anymore, because it was going to cost money," she said. "The actual emergency room, when I finally did get him to go in, was $1,800. And that’s out of pocket, because insurance doesn’t pay for any of it."
Platz said, "It’s just good practice to make sure, one, what will insurance cover, and two, what’s it going to cost."
In general, she said, "You just don’t go to the doctor unless you’re really sick, in major pain, or it’s your annual physical, because your insurance doesn’t cover anything except your annual physical. Period. That’s the way our insurance is, anyway."
Happy to be insured
But the picture seems to be a much better one for those with more stable health plans, such as that available through employment with the federal government and via Medicaid.
Stacy Schroeder of Parkers Prairie works as a nurse at the VA clinic in Alexandria and describes her federal insurance as "great."
She pays $500 to $600 a month for family insurance, which covers pretty much everything, she said. She has no deductible.
Al Marty, 66, of Menahga owns the Music Shop in downtown Park Rapids. He went for some years without health insurance, but now he has Medicare.
Regarding out-of-pocket costs, he said, "In my case, they’ve gone down, on account of I was uninsured for quite some time, and now I am insured. I’m grateful for that, but I do notice, yes, that things are going up consistently."
Due to healthcare costs, he said he is "always living pretty close to the bone."
Marty voiced concern that healthcare costs keep rising "in greater proportion than what my annual income does. I suppose it’s going to be more and more of a concern as I age further. For now, I’m happy to be insured again."
Reporters Robin Fish, Karen Tolkkinen and Patrick Springer contributed to this story.