As health costs soar, Utahns are skipping medical care, taking on debt and dipping into savings to afford their health care, a new survey found.
The One Utah Health Collaborative surveyed 1,000 Utahns and found that affordability pressures and uneven institutional trust are straining their confidence in health care.
It also found Utahns think the state is and should remain one of the biggest players working to improve the state’s health care system.
Learning what people think was the easy part, said Scott Barlow, executive director of the One Utah Health Collaborative, a group that’s been working for three years on providing affordable care to improve Utahns’ quality of life.
It’ll be harder to figure out what to do about what’s broken in the health care system, he said.
“We all own this problem. There are no villains here,” Barlow said during a recent webinar about the survey results. “This isn’t going to happen overnight. This is going to be thousands of little steps of progress.”
‘One bill away’ from financial trouble
Between 2021 and 2023, the amount Utahns spent on average grew from $7,547 to $8,183 — an 8.4% jump.
Utahns use the medical system constantly, the survey results show, from filling prescriptions to going to the doctor’s office or urgent care to using telehealth.
“This is everyday life,” said Sri Bose, the collaborative’s director of research.
But rising costs and confusion are eroding people’s confidence in the system, Bose said.
Rather than insurance, Utahns are frequently using their own pocketbook to pay expenses, she said – and 61% of respondents with insurance had paid fully out-of-pocket in the previous year for at least one medical expense, including prescriptions, medical supplies and substance use disorder treatment.
And that routine care is becoming harder to afford for most Utahns, Bose said, with many about $1,000 away from needing to borrow money or incur debt to pay medical bills.
“They’re all one bill away from having a financial strain,” she said.
More than 20% already have borrowed money or relied on credit to cover costs, the results show, and others are anticipating those costs and skipping or delaying care.
People are even avoiding preventive care, said Dr. Sarah Woolsey, a family medicine doctor who’s also the director of clinical affairs for the Association for Utah Community Health.
They’re afraid of what it will cost, she said, or what a test result could mean for future costs.
“There’s a despair there,” she said, with people increasingly turning away from traditional care and getting something over the counter or online, “on the off chance that it will make them feel better.”
Patients are also more confused about their insurance, Woolsey said, especially when it comes to high-deductible plans. They spend a lot of time trying to figure out how they can afford their care, she said, and that erodes trust.
More trust in people than the system
The survey results indicated Utahns have some real trust issues with the health care system, Bose said.
More than 75% of respondents at least somewhat trust clinicians, but less than 40% trust insurance providers to be fair in their coverage and that hospitals have transparent pricing.
“Utahns trust people more than the system that surrounds them,” Bose said, stressing that dissatisfaction isn’t about the care they receive.
There’s appetite for systemic changes, she said, with 83% of respondents wanting at least some adjustment.
About half of the respondents said the system works well overall but needs some changes, and close to ⅓ want major reform. Only 17% said the system doesn’t need to change at all.
Utah is working toward that change, said Dan Nelson, the CEO of GBS Benefits, a consulting firm that partners with employers providing health insurance.
Health care is unlike anything else, he said, comparing the way we purchase care to going to the grocery store, filling your cart and only finding out the costs at the register.
But Nelson remains optimistic. If there is any state that can “positively impact” health care affordability, he said, it’s Utah.