By Tom Purcell

“I’m lucky to have health insurance, but I still can’t afford to go to the doctor.”

“Ah, yes, you speak of a growing problem in health care. According to NextAvenue.org, between ‘a third and a half of people age 45 to 59 and a quarter of those 60+ went without needed health care in the past year due to its cost.’ That was the finding of a recent survey by West Health Institute and NORC at the University of Chicago.”

“My health insurance used to cover most of my costs. Now I have extremely high deductibles that require me to pay hundreds and hundreds of dollars out of pocket before the insurance coverage kicks in. That’s making me avoid going to the doctor.”

“You are not alone. According to the findings, nearly half of the 45 to 59 year olds surveyed ‘did not go to the doctor last year when they were sick or injured.’ Nearly half skipped recommended medical tests or treatment.”

“It’s even worse than that. Due to the expensive deductibles and co-payments, I stopped getting my annual physical. I know an ounce of prevention is worth a pound of cure, but I simply can’t afford preventive care.”

“That certainly isn’t good. One doctor told NextAvenue.org that chronic diseases, such as hypertension and diabetes, are huge problems for millions. He said that early detection and intervention can address them, but left untreated they can lead to heart disease, kidney failure and a risk for getting a stroke.”

“I tell you what may give me a stroke: opening the stacks of bills I get for any medical treatment I do receive! It’s always way more costly than I expected it to be.”

“That’s also a growing problem. The survey found that ‘54 percent of Americans say they received a medical bill in the past year that they thought was covered by insurance [but wasn’t] and 53 percent got one where the amount they owed was higher than expected.’”

“It’s a total mess. I call the doctor and the hospital to try to figure out why I owe so much, but nobody has a clue.”

“NextAvenue.org says transparency into medical bills and a lack of competition among health care providers are two considerable challenges. According to Dr. Zia Agha, chief medical officer at the West Health Institute, the lack of transparency and competition limit consumer choices. Since consumers lack the information they need to make smart, informed health-care choices, they are unable to choose the most affordable care, which ultimately drives costs up.”

“Yeah, well I’ll tell you what has really driven up my health-care costs up: Obamacare. My premiums and deductibles have increased dramatically since Obamacare was passed into law!”

“What you say is a fact. According to Forbes it turns out that ‘across the board, for all ages and family sizes, for HMO, PPO, and POS plans, premium increases averaged about 60 percent from 2013, the last year before ACA reforms took effect, to 2017.’”

“I know it is true. People say the crazy stories about some families seeing massive increases in premiums and deductibles are hyperbole, but it is not! Millions can’t afford their health insurance now!”

“That is true, too. According to Kaiser Health Foundation polls, ‘37 percent percent reported having trouble affording health insurance premiums, up from 27 percent in 2015, and 43 percent had trouble affording deductibles, up from 34 percent.”

“I’m no health care policy expert, but cost is the primary problem with health care in America. Until we implement true reform that unleashes competition and takes other steps to drive down costs – until we restore premiums and deductibles to prices that average Joes like me can afford — I’ll be sick to my stomach, but I still won’t visit a doctor!”

Tom Purcell is a nationally syndicated humor columnist and author of “Misadventures of a 1970’s Childhood,” a humorous memoir available at amazon.com.