Uninsured numbers up

[irishbobcat]

Number of Underinsured American Adults Rising

June 17, 2008

The number of underinsured U.S. adultsâ€"that is, people who have health coverage that does not adequately protect them from high medical expensesâ€"has risen dramatically, a Commonwealth Fund study finds. As of 2007, there were an estimated 25 million underinsured adults in the United States, up 60 percent from 2003.
Much of this growth comes from the ranks of the middle class. While low-income people remain vulnerable, middle-income families have been hit hardest. For adults with incomes above 200 percent of the federal poverty level (about $40,000 per year for a family), the underinsured rates nearly tripled since 2003.

Middle-Income Uninsured Rate Rising

Insurance erosion has spread up the income distribution well in to the middle-income range. For those with annual incomes of $40,000 to $59,000, the underinsured percentage rate reached double digits in 2007. Barely half of those with incomes of 200 percent to 299 percent of the poverty level were insured all year with adequate coverage.

Underinsured Go Without Needed Care

In terms of access problems and financial stress, underinsured peopleâ€"even though they have coverage all yearâ€"report experiences similar to the uninsured. More than half of the underinsured (53%) and two-thirds of the uninsured (68%) went without needed careâ€"including not seeing a doctor when sick, not filling prescriptions, and not following up on recommended tests or treatment. Only 31 percent of insured adults went without such care.

About half of the underinsured (45%) and uninsured (51%) reported difficulty paying bills, being contacted by collection agencies for unpaid bills, or changing their way of life to pay medical bills. Many reported that they took on a loan, a mortgage against their home, or credit card debt to pay their bills, suggesting, "that these financial difficulties had the potential to linger into the future." In contrast, only 21 percent of insured adults reported financial stress related to medical bills.

Benefit Design Matters

The sharp increase in the number of underinsured adults is partly due to design changes in insurance benefits that leave individuals financially vulnerable. Underinsured adults were more likely than those with adequate insurance to report benefit limitsâ€"for example, restrictions on the total amount a plan would pay for medical care or on the number of physicians' visits allowed. They were also far more likely to report high deductibles: one-quarter had annual per-person deductibles of $1,000 or more. Despite benefit limits and higher deductibles, underinsured adults often reported high annual premium costs, in line with those reported by more adequately insured people.

"Benefit design matters," the researchers conclude. Having a policy with substantial cost sharing relative to income can undermine access to care and erode family finances. While improving insurance coverage is a worthy goal, it is important for policymakers to consider cost-sharing provisions, scope of benefits, and income when exploring coverage mandates, they say. Single-Payer Health Coverage such as the Health Care for All Ohioans Act would help.

The goal is high-quality care and improved outcomesâ€"not just coverage, There is growing recognition of the need for coherent strategies that combine coverage with payment and other policies to change directions and move toward a more inclusive and higher-performing, high-value health system.

Yesterday, I received an e-mail from a professor from Case Western Reserve University who shared the following information:

“In my view, there are a few other absolutely critical facts that are not mentioned by Mr. Spisak and generally overlooked by most healthcare activists. 

1.  The insured do not know what their insurance covers until they get an expensive disease.  Most voters are insured, and they do not understand how bad their situation may become when they develop widespread cancer.  Their premiums may be increased because they are sick (everyone buys insurance so as to be insured while they are healthy, don't they?).  The insurance company may find ways not to pay for some needed diagnostic tests and/or treatments.

2.  Physicians sometimes change what is done for expensive diseases based on what insurance companies cover.

3. Insurance companies can and do change what they are willing to pay for without the knowledge of their insured.

4. Some physicians, hospitals, etc. collaborate with insurance companies to make these companies more profitable.

In my opinion, we shall not solve our problem until (a) the insured become very concerned and (b) there is universal monitoring of (1) quality of care and (2) who got paid for what.

As the Independent Green Party Candidate for State Representative for the 60th District, I believe we nee to pass the Health Care for All Ohioans Act. Current State Rep Bob Hagan said on WKBN radio on December 31, 2007 the biggest crisis facing Ohioans today was health care, and the problem to fixing health care was insurance companies. What Bob Hagan forget to tell the radio listeners he has taken political donations from insurance companies like Medical Mutual within the past year. So who do you represent in Columbus, Bob? People who need insurance or the insurance companies?

Dennis Spisak-Independent Green Party Candidate for State Rep-60th District

Campaign Site: Http://votespisak.tripod.com

See our links page to the Health Care Reforms