Healthcare has long been a burden for working Americans and retirees alike, so much so that more than half of U.S. adults routinely delay medical treatment because they don't have the money to pay for it. The problem has gotten so bad, in fact, that the ability to tend to medical issues may boil down to whether or not Americans get a tax refund.

In 2016, consumers collectively increased their out-of-pocket healthcare spending by 60% in the week after they received their tax refunds, according to a report by the JPMorgan Chase Institute. Spending then remained elevated for roughly 75 days, during which time Americans spent 20% more on healthcare than they did prior to receiving refunds. Clearly, this data affirms the aforementioned troubling trend -- that Americans are delaying medical care because they can't afford it without some sort of windfall.

Man coughing in bed, with thermometer and pills on a bedside table.

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The good news is that the majority of tax filers do wind up with a refund upon submitting their returns. In 2016, 73% of filers got money back from the IRS, with an average refund of $2,860. And an estimated 80% of filers will be looking at refunds in 2019 once their 2018 taxes are completed. Still, that's little consolation for folks with pressing health issues who can't afford to wait that long.

Don't let health issues escalate

The problem with delaying medical care is that in doing so, you'll often cause issues to not only worsen, but grow more expensive. Imagine you have a nagging cough that just doesn't seem to want to go away. If you're worried about covering the cost of an exam and chest X-ray, you might delay that appointment for weeks or months in an effort to wait for your tax refund to cover it. In that time, however, that cough has the potential to evolve into full-fledged pneumonia, which, if you're older or have an underlying condition, could easily land you in the hospital with bills ranging into the thousands. At the same time, you'll be putting yourself at risk of succumbing to a potentially lethal disease.

You might argue that this is somewhat of an extreme scenario, but it can certainly happen. And since tax refunds come around only once a year, relying on them in the absence of other savings can really put your health and finances at risk.

You can't rely on refunds alone

You're probably aware that you should plan on spending a portion of your income on medical care. But what happens when you hit a string of doctor visits or require a procedure that's outside your budget? Rather than plan to just put off the care you need, build some emergency savings so you have reserves to fall back on when unexpected health issues arise. You may need to cut back on living expenses or get a second job temporarily to drum up that cash, but consider it a worthwhile investment in your health.

At the same time, take steps to lower your healthcare costs. Shop around for a better insurance plan if yours leaves you on the hook for higher co-pays and deductibles than you can afford. Be smart about buying prescriptions so you're not overpaying, whether that means ordering in bulk or insisting on generics. And don't hesitate to let your providers know when you're paying for services out of pocket. Often, they'll either negotiate a more affordable rate than what they'd charge your insurance company, or, at the very least, allow you to get on a reasonable payment plan.

Relying on tax refunds to stay healthy is bad news, so if that's been your go-to tactic thus far, it's time to change your way of thinking -- especially since they're not guaranteed. That said, if you do get a tax refund in the coming year and don't have any immediate medical issues to tackle, bank that money so that if you encounter health problems down the line, you'll have some cash reserves to tap. Still, be proactive in lowering your costs so that the next time a health problem does arise, it won't be quite so expensive.

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