Though such care isn't urgent, skipping it could have serious consequences, including cancers caught late when they could have been detected early, or high blood pressure culminating in a stroke when it could have been controlled.
"What we can confidently say is that people will die because of this economic downturn," said Dr. Andrew Wilper, an instructor of internal medicine at the University of Washington.
He said the demand on Veterans Affairs hospitals was also increasing as more people lost private health insurance.
Most laid-off workers of low or moderate incomes can't afford to keep their insurance through COBRA (the federal law that allows employees to keep their job-based health insurance for three years after they lose or leave a job, if they pay the entire premium) and do not qualify for public health programs for the poor.
A study by Wilper published in August in the Annals of Internal Medicine estimated that about 25% of uninsured adults had chronic health conditions such as diabetes or emphysema but did not receive regular care to ensure the conditions were well-managed. Twenty-two percent said they had not seen a doctor in the last year, compared with 6% of insured people.
Another study, published last month in the Archives of Ophthalmology, found that 14% of people without health insurance had seen an eye doctor in the last year.
Skipping routine care can allow small problems to become bigger.
An 11-year study in San Francisco found breast cancer tumors were more likely to be diagnosed at an advanced stage during periods of high unemployment.
Kimberly Ragucci, a graphic designer, has a high-deductible health plan that pays for expenses only after she has spent $5,000 in a year.
The 23-year-old mother, who lives in Long Beach, doesn't have dental or vision insurance. She takes her son for regular pediatric care, but barring a medical emergency, she said she didn't plan to seek healthcare for herself any time soon.
"I have astigmatism, and I need a new prescription," she said. "I haven't been to the eye doctor for more than two years. And ever since I got pregnant, my teeth have moved a lot. I know I need to see a dentist, but I can't afford it."
More than 17% of Americans under 65 have high-deductible plans like Ragucci's, the Centers for Disease Control and Prevention said.
