Consumer Reports Health Care Survey
August 6, 2007
Summary of Key Findings
A survey of the health care experiences of 2,905 nationally representative respondents was conducted in May, 2007. We focused on respondents’ experiences of the past 12 months. The population sampled was U.S. residents between the ages of 18 to 64 who were covered by neither Medicare nor Medicaid.
Our findings indicate that there are three tiers of health care consumers in the United States: the adequately-insured, who account for 59% of all Americans in the population sampled; the underinsured, who represent 24% of all Americans sampled; and the uninsured, who comprise 16% of our sample.
From a list of possible complaints about their health plans, respondents were asked to indicate which characterized their plans. Our initial factor analysis identified 6 specific, highly-correlated items that collectively defined our scope of coverage dimension. An additive scale was constructed from these items. We found that at the plateau of two complaints, the health care experiences of insured respondents diverged sharply. Those insured respondents with two or more complaints have been identified as the underinsured. To illustrate the depths of these concerns, 63% of the underinsured indicated their health plan does not adequately cover prescription drug costs.
Our principal finding is that the underinsured represent a large segment of the American population between the ages of 18 to 64: 29% of all persons with health plans, and 24% of the population as a whole. Although the travails of the uninsured have been widely-documented, our observation is that the uninsured represent only one segment of those lacking adequate health insurance. When we add together the uninsured (16%) with the underinsured (24%), we find two-fifths of a nation burdened by health care jitters.
Here is a sample of the experiences of the underinsured in the past 12 months:
56% postponed needed medical care because of costs
33% had to dig deep into their savings to pay medical expenses
34% of those 50+ said decisions about retirement were adversely affected by health care expenses
21% made job-related decisions based _mainly _on health care needs.
27% had outstanding medical debts still owed doctors or hospitals, and 17% were carrying medical debts of $5,000 +
38% postponed home or car maintenance or repairs due to medical expenses
71% indicated they were dissatisfied with their household’s share of out-of-pocket medical expenses
37% said they were at all prepared to financially handle unexpected major medical expenses they might face in the next 12 months.
In short, these data warrant a more expansive discussion about health care policy in the U.S. Recognition of the problems of the 16% who are uninsured acknowledges only part of the story. Respecting the burdens of an additional 24% with inadequate health plans compels a more thorough assessment of what ails the health care system.
Unlike the uninsured, who stand out as distinctly less affluent, less educated, and less white than the insured population, the underinsured are not demographically distinct from their adequately-insured compatriots. Their median income of $58,000 is about twice as great as the median incomes of the uninsured. They are just as white, and nearly as well-educated, just as likely to work full-time and to work in large or medium-sized companies. They could well be the neighbors of the adequately insured.
There is luck-of-the draw eeriness about these findings. Most riveting are the responses to a survey item asking respondents whether their current health plan is better or worse than the plan they had prior to it. One-quarter of the underinsured qualified to answer. Only 30% of them rated their current plan as better, and 51% worse, than their previous plan. These are disturbing findings consistent with our knowledge of the persistent pressure on employers to offer less comprehensive benefits to meet the rising costs of their health insurance premium payments.