As a pulmonary and critical care physician at Yale, I have a front row seat at the medical debt crisis. While many people associate medical expenses with visits to a hospital, doctor, or the purchase of medication, there is one often overlooked cost that can have a profound impact: durable medical equipment.
In my practice, I often prescribe durable medical equipment (DME), such as oxygen concentrators, walkers, ventilators, or other equipment to help my patients live a healthier life. While patients’ insurers will typically pay for the equipment itself, the resulting increase in their electrical bills can be substantial. My research, published in the Journal of the American Medical Association, has shown that these bills can easily be hundreds of dollars a year, and in some cases, more than $1,000.
This cost can be especially burdensome for my patients who are on Medicaid, as their severe health problems often make it hard to maintain employment and live on a fixed income. They simply cannot afford these huge bills. I, along with my colleagues, have seen firsthand how this financial burden can have a devastating impact on their quality of life and medical care.
As a society, we must recognize that the cost of medical care is not limited to visits to the doctor or the cost of medication. The financial burden of DME can have a lasting impact on the lives of our most vulnerable citizens. We must take steps to address this issue and ensure that everyone has access to the medical equipment they need to lead healthy and fulfilling lives.
There are several potential solutions to this problem. One solution is to expand funding for the Low-income Home Energy Assistance Program (“LIHEAP”), which helps more than 5 million low-income households annually with payments on the electric, gas, oil and propane bills, helping them to stay warm in the winter and cool in the summer. But existing funding is inadequate to reach the 30 million households that are eligible. More funding would be needed to target additional payments to those with extraordinarily high electric bills due to reliance on DME.
Another solution would involve payers of medical bills (Medicare, Medicaid, private insurers) to pay not only the cost of the equipment itself but also to defray the cost of the increased electric bills.
A third option is to provide tax incentives to individuals who need DME, so they can offset the costs associated with it.
Ultimately, the solution will likely involve a combination of these approaches and perhaps others. However, what is most important is that we take action. The cost of medical care is a complex and challenging issue, but we cannot afford to ignore the impact it has on the lives of patients.
Dr. Peter Kahn is a fellow in the Section of Pulmonary, Critical Care and Sleep Medicine at Yale School of Medicine. He graduated from the Albert Einstein College of Medicine with honors and his M.P.H. from the Johns Hopkins Bloomberg School of Public Health in the department of Health Policy and Management. Dr. Kahn’s research has focused on health policy with a particular interest in the impact of climate change and utilities on health policy. Follow him on Twitter @PeterKahnMD
Charlie Harak is senior attorney for energy and utilities issues at the National Consumer Law Center. He represents consumers before regulatory agencies, testifies at legislative hearings, and provides legal and policy counsel to low-income advocates, legal services lawyers, and government officials. He is the co-author of “Protecting Seriously Ill Consumers from Utility Disconnections: What States Can Do to Save Lives Now” (Feb. 2021).