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Editorial
September 13, 2004

Don't Ask, Don't TellThe Status of Doctor-Patient Communication About Health Care Costs

Arch Intern Med. 2004;164(16):1723-1724. doi:10.1001/archinte.164.16.1723

Users of health care, both young and old, face increasingly hard times when it comes to paying for care. Medication and health services costs are rising faster than inflation.1 Increasing numbers of Americans lack health care coverage, nearly 44 million at the last count, and health care insurance, including managed care and employer-based coverage plans, continues a sharp trend in shifting costs onto patients.24 Medicare premiums, for example, rose 13.5% in January, one of the largest annual increases in the program's history. Many seniors, even with the support of the new Medicare prescription drug benefit, will have prescription drug expenditures exceeding 10% of their annual income.5 The combination of greater cost sharing and higher prices for medical care will increasingly drive patients to forgo medications and other services.

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