Delaying Health Care Reform Costs Money and Lives

USA Unsafe = 46 Million Uninsured + 47 Million Under-Insured

Lack of health insurance has always been a problem for America’s poor but recent studies show that America’s middle to upper level working families are also feeling the bite of high health insurance costs resulting in loss of coverage, strapped medical debt and difficulties accessing basic required care.

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National health care spending is climbing by more than 7% per year, outpacing economic growth by a substantial margin. As health care costs have climbed, so has the number of people without health insurance in the United States, even during a period of overall economic growth. In 2004, according to U.S. Census data, nearly 46 million people of all ages were uninsured, an increase of 6 million over 2000. This combination of eroding health insurance coverage and rapidly rising health care costs raises concerns about the ability of U.S. families to obtain timely medical care, protect their finances from catastrophic health care costs, and save for retirement.

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Rising Numbers of Uninsured Individuals Are in Moderate and Middle-Income American Families

Two of five (41%) working-age Americans with incomes between $20,000 and $40,000 a year were uninsured for at least part of the past year—a dramatic and rapid increase from 2001 when just over one-quarter (28%) of those with moderate incomes were uninsured.

Adults with incomes under $20,000 were still the most likely to be uninsured: more than half (53%) had spent time uninsured in the past year.

Most people who are uninsured are in working families. Of the estimated 48 million American adults who had any time uninsured in the past year, 67% were in families where at least one person was working full time.

Many Americans Report Medical Bill Problems and Medical Debt

One-fifth (21%) of working-age adults, both insured and uninsured, currently have medical debt they are paying off over time and more than two of five (44%) of these individuals are carrying $2,000 or more in debt.

More than one-third (34%) of adults ages 19 to 64 either had medical bill problems in the past year or were paying off accrued medical debt. Problems include not being able to pay bills, being contacted by a collection agency about unpaid medical bills or having to change their way of life to pay bills.

Three of five (62%) of all adults with medical bills or debt problems said they or their family member were insured at the time the debt was incurred.

More than half (51%) of uninsured adults reported medical debt or bill problems. Of those, nearly half (49%) used up all their savings to pay their bills. Two of five were unable to pay for basic necessities like food, heat or rent because of medical bills.

Rates of medical bill problems and debt were high among people in both lower-income and higher-income households who experienced a time uninsured. Indeed, rates were highest among those with higher incomes. Nearly three of five (59%) adults with incomes of $40,000 or more reported difficulties with medical bills or accrued debt. Forty-six % of adults with higher incomes were paying off unpaid medical bills over time, with over half (54%) of these individuals carrying $2,000 or more in medical debt.

People With Gaps in Coverage Have Difficulty Managing Chronic Conditions

An alarmingly high proportion—59 %—of uninsured adults who had a chronic illness, such as diabetes or asthma, did not fill a prescription or skipped their medications because they could not afford them.

More than one-third (35%) of uninsured adults who had a chronic condition went to an emergency room or stayed overnight in the hospital in the past year because of their condition—about two times the rate of people with chronic health problems who were insured all year.

Individuals With Gaps in Coverage Are Much Less Likely to Get Preventive Care

Only 18 % of uninsured adults ages 50 to 64 had a colon cancer screen in the past five years, compared with 56% of adults insured all year.

Less than half (48%) of uninsured women ages 50 to 64 had a mammogram in the past two years, compared with 75% of women who were insured all year.

Few adults without medical insurance receive dental care: only 35% of those uninsured at the time of the survey had a dental exam in the past year, half the rate of those who were insured for the full year.

People With Gaps in Coverage Experience Inefficient Care

Nearly one-quarter (23%) of adults who reported spending any time uninsured in the past year said test results or medical records were not available at the time of a scheduled appointment, compared with 15% of continuously insured adults.

Nearly one of five (19%) adults with any time uninsured said he or she had been given a duplicate test, twice the rate of duplication reported by continuously insured adults.

S. R. Collins, K. Davis, M. M. Doty, J. L. Kriss, and A. L. Holmgren, Gaps in Health Insurance: An All-American Problem, The Commonwealth Fund, April 2006

Gaps in Health Insurance: An All-American Problem, April 2006 http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2006/Apr/Gaps-in-Health-Insurance–An-All-American-Problem.aspx

Under Republican Administration America’s Middle Class Lost Health Insurance.

Diminishing Coverage

Middle class Americans and their families are facing a growing challenge in obtaining or maintaining their health insurance coverage.

Over a quarter of the uninsured are middle class Americans.
The number of non-elderly middle class Americans who are uninsured has grown over time, from 11.1 million in 2001 to 12.5 million in 2007. Looking forward, without health reform, the number of middle class Americans without health insurance could be as high as 18.2 million in 2019.

In part, high rates of the uninsured among middle class Americans arise because middle income workers have a higher chance of not being offered health insurance through their job. In fact, of the 10.7 million non-elderly adults in the middle class bracket who are uninsured, nearly 90% are employed.

Nearly one in four middle class employees are not offered health insurance by their employers – and of those that are not, more than half remain uninsured. In comparison, only one in six high-income employees are not offered health insurance by their employers.

Part of the reason that middle income Americans are less likely to be offered coverage is because they are more likely to work in small businesses – 53% of middle income Americans work in small businesses, compared with 46% of higher income Americans. Of those who work in small business, 40% are not offered insurance.

Reduced Access to Care
Shrinking coverage and rising costs mean middle class Americans are finding it difficult to obtain the care they need.

11% of middle class adults reported delaying needed care and 8% reported avoiding care altogether because of high cost in 2007.

Middle class adults are also more likely to avoid care because of rising costs compared to higher-income adults, where only 5% reported delaying and 3% reported avoiding needed care.

The problem is particularly worse for those middle class adults who are uninsured, where more than one in five delayed or avoided needed care because of cost in 2007.

Regular visits to the pediatrician are important for healthy child development, and yet too many middle class children do not see a physician regularly. 12% of middle class children did not have a health care visit in the past year, compared to 8% of high-income children.

Task Force Report on Uninsured and Underinsured in Middle Class (Sept 2009)

Study Links 45,000 U.S. Deaths to Lack of Insurance

Nearly 45,000 people die in the United States each year — one every 12 minutes — in large part because they lack health insurance and cannot get good care, Harvard Medical School researchers found in an analysis released on Thursday.

“We’re losing more Americans every day because of inaction than drunk driving and homicide combined,” Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.

Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.

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Study co-author Dr. Steffie Woolhandler said the findings show that without proper care, uninsured people are more likely to die from complications associated with preventable diseases such as diabetes and heart disease.

(Editing by Xavier Briand) WASHINGTON (Reuters)
Source: http://www.reuters.com/article/healthNews/idUSTRE58G6W520090917