Financial Anxiety Higher Medical Fees Increase Expectations of Physical Pain

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The price of a medical procedure may shape how painful patients expect it to be. Across three experiments, higher out-of-pocket costs increased anticipated discomfort and reduced willingness to book appointments, with financial anxiety helping to explain the effect.

Rising out-of-pocket medical costs do more than damage a patient’s bank account. New research shows that expensive healthcare prices cause people to expect greater physical pain during medical procedures, driving many patients to skip necessary appointments altogether.

The study, “Paying for Pain: How Healthcare Costs Influence Physical Pain Predictions,” was co-authored by Helen Colby, Carnegie Mellon, Deidre Popovich, Texas Tech, Ashley Angulo, University of Oregon, and Kellilynn M. Frias, American University, and published in Psychology & Marketing. Their research reveals that financial distress involving medical procedures directly spills over into sensory expectations. When patients face higher out-of-pocket fees, they experience heightened immediate financial discomfort. That discomfort triggers broader financial anxiety, which leads the brain to anticipate significantly more physical pain from procedures ranging from simple blood draws to complex endoscopies.

Researchers discovered this emotional spillover effect across three distinct experiments. In each scenario, participants evaluated identical medical procedures with identical clinical details, varying only the out-of-pocket price. When prices increased, participants consistently predicted higher physical discomfort and were less willing to schedule appointments.

“We found that the psychological pain of paying money doesn't stay separate from our physical expectations,” said Helen Colby, Assistant Teaching Professor of Marketing at The Tepper School of Business and lead author of the study. “When a medical test costs more out of pocket, people mentally brace for a more painful physical experience. Financial anxiety changes how we construct the prospect of healthcare in our minds before we ever set foot in a doctor's office.”

The findings highlight a critical vulnerability for consumers already facing tight budgets. General financial stress amplifies this reaction, making low-income or financially strained individuals the most likely to delay medical care due to cost-induced fear of pain.

“Healthcare providers and marketers need to realize that price tags carry heavy emotional weight,” Colby said. “Communicating lower-cost options, offering clear payment plans, or framing preventive care as low-cost can lower financial anxiety. By reducing the pain of payment, we can decrease expected physical discomfort and encourage patients to get the medical care they need.”

Original Article: Paying for Pain: How Healthcare Costs Influence Physical Pain Predictions; Psychology and Marketing; DOI:10.1002/mar.70261

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