A 100-year-old patient, care paused by cost
​Healthcare coverage continues to expand, but cost pressure at the point of care is rising.
This is where care decisions are increasingly being made, not at enrollment, but at execution.
 
A Real Case, Last Week
A 100-year-old woman in Massachusetts had an approved care plan that could not move forward.
Her daughter, her caregiver and healthcare proxy, did not start with the medical issue.
She started with the numbers.

$57 left each month.
After everything else was paid.
The care plan was clear:

• A hospital bed
• A low-pressure air mattress
• Standard prevention for pressure ulcers

She secured the bed.
But the mattress, the part that makes the care plan medically effective, required about $1,300 out of pocket.
That is where the plan paused.
Not because care was unavailable.
Not because the system failed.
Because of cost at the moment care was supposed to happen.

What This Signals
The care existed.
The prescription existed.
The system existed.

Completion still required an additional step.
Without the mattress:

• Pressure ulcers become more likely
• Infection risk increases
• Hospitalization becomes more likely

At 100 years old, those risks carry weight.
 
The Pattern Behind the Story
This is not an isolated case.
Across our Healthcare Cost Assistance Program, most care interruptions occur at much smaller dollar amounts, often under $75.
​But higher cost gaps like this still surface at time-sensitive points in care, particularly when durable equipment or specialized support is required.

The pattern is consistent:
Care does not typically break at the point of access.
It breaks at the point of completion.
 
Why It Matters
Significant investments continue to expand healthcare access, coverage, and infrastructure.
But those investments do not guarantee that care is carried through.
The final step, whether care is actually completed, remains financially exposed.
 
The Outcome
In this case, the missing piece was filled.
The care plan moved forward.
 
The Takeaway
The system delivered care.
Completion still had a cost.

A closer look at what happens after care begins

Nearly half of women veterans have canceled a medical appointment because of childcare
Not because care wasn’t available.

Not because they didn’t seek it.

Because something outside the clinical setting got in the way.

For years, the conversation has focused on access:
How do we get people into care?
But for many women veterans, especially mothers, the challenge begins after the appointment is already scheduled.

Eight in ten women veterans report satisfaction with the care they receive
Access has improved.

Trust is high.
And yet, care is still being interrupted.
One of the most consistent reasons is not clinical.

It’s logistical.

Childcare.

42% of women veterans ages 18–34 and 36% ages 35–44 require childcare during medical appointments
40% report difficulty finding childcare for those appointments
46% have canceled a medical appointment in the past year because of it

These are not access failures.
They are completion breakdowns.
Care was scheduled.
Care was needed.
Care did not happen.

This pattern extends beyond any single barrier.

Approximately 4 in 10 U.S. adults report delaying or skipping recommended medical care due to cost, Kaiser Family Foundation

Even among insured populations, a significant share still forgo care due to out of pocket expenses, The Commonwealth Fund

Different barriers. Same outcome.

Care is interrupted.

This is not a question of motivation.
It is not a question of awareness.
And it is not a reflection of system quality.

The issue is something else:
The conditions required to complete care are not always in place.

Where MNF Fits
The Medic Now Foundation focuses on what happens between scheduling care and completing it.
For many women veterans, that gap is not clinical.

It’s practical.
Childcare is one example.
Out-of-pocket costs are another.

These are small, time-sensitive barriers, but they can determine whether care happens at all.
Healthcare systems perform best when patients are able to complete the care they begin.
Care that is started but not completed is still lost care.

The challenge today is no longer just access.

It’s completion.

Sources
Study of Barriers for Women Veterans to VA Health Care, 2023–2024, U.S. Department of Veterans Affairs
Advisory Committee on Women Veterans, 2024 findings, U.S. Department of Veterans Affairs
Kaiser Family Foundation
The Commonwealth Fund