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NAVIGATION PNHP RESOURCES
Posted on October 3, 2005

Pandemic of under-insurance

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Medical Debt and Access to Health Care
Prepared by Catherine Hoffman, Diane Rowland and Elizabeth C. Hamel
The Kaiser Commission on Medicaid and the Uninsured
September 2005

Health insurance alone is no longer a guarantee of financial protection from the costs of health care for many. Today’s higher premiums, deductibles, and copayments can create a substantial financial burden for families and many learn only through an unexpected serious injury or illness that they are not well protected financially.

In this study… we found that one in six adults who are privately insured - 17.6 million adults - report having substantial problems paying their medical bills.

Privately insured adults with medical debt are largely from middle-class families, not as poor as the uninsured, but not as well-off as the privately insured who have no medical debt. The large majority hold full-time jobs. An important difference between the privately insured with vs. without medical debt is their health status. Those with medical debt are more than twice as likely to report being in only fair or poor health and they are almost twice as likely to have an ongoing or serious health problem compared to others with private coverage.

Perhaps not surprising, the majority of those with medical debt reported underestimating what their health plan would pay towards their medical bills (vs. a third of those without sizable medical debt) and nearly half said their plan had not paid anything for care they thought had been covered.

If current trends in greater cost-sharing continue, more low- and middle-income families with private insurance, particularly those who are in less than good health, will not have the same access to care as others with private coverage who have higher incomes. In fact, as this study shows, they will limit their care in many of the same ways and as often as those who have no health insurance at all.

http://www.kff.org/uninsured/upload/Medicaid-Debt-and-Access-to-Health-Care-Report.pdf

Comment: Monotonous, isn’t it - study after study demonstrating that private health insurance is no longer serving its purpose - to ensure financial security for those who have health care needs.

Current insurance innovations are designed to make premiums affordable, and they do this by making access to care unaffordable. The insurers are not going to fix this broken system for us. Isn’t it time that we gave up on them?