Kaitin

Too many people in the US are uninsured, including many children.

From the New York Times: Survey Finds 43.6 Million Uninsured in U.S.

About 43.6 million people in the United States, or 14.8 percent of the population, had no health insurance in 2006, according to a survey by the Centers for Disease Control and Prevention released Monday.

The finding, based on a survey of 100,000 people, is lower than previous federal estimates of 46 million.

The estimate is based on those who did not have insurance at the time of the interview. About 54.5 million people in the country, or 18.6 percent of the population, had no insurance for at least part of 2006.

The survey, by the National Center for Health Statistics, found that about 9.3 percent of children under 18 did not have health insurance, a decrease from 13.9 percent in 1997.

Texas had the largest percentage of people without health insurance, with 23.8 percent of the population not covered, the report said. Michigan had the lowest, at 7.7 percent.

---

Medical bills are a huge problem and cause bankruptcy, even with insurance but more problems without insurance.

From ConsumerAffairs.Com: Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds

Illness and medical bills caused half of the 1,458,000 personal bankruptcies in 2001, according to a study published by the journal Health Affairs.

The study estimates that medical bankruptcies affect about 2 million Americans annually -- counting debtors and their dependents, including about 700,000 children.

Surprisingly, most of those bankrupted by illness had health insurance. More than three-quarters were insured at the start of the bankrupting illness. However, 38 percent had lost coverage at least temporarily by the time they filed for bankruptcy.

Most of the medical bankruptcy filers were middle class; 56 percent owned a home and the same number had attended college. In many cases, illness forced breadwinners to take time off from work -- losing income and job-based health insurance precisely when families needed it most.

Families in bankruptcy suffered many privations -- 30 percent had a utility cut off and 61 percent went without needed medical care.

The research, carried out jointly by researchers at Harvard Law School and Harvard Medical School, is the first in-depth study of medical causes of bankruptcy. With the cooperation of bankruptcy judges in five Federal districts (in California, Illinois, Pennsylvania, Tennessee and Texas) they administered questionnaires to bankruptcy filers and reviewed their court records.

Dr. David Himmelstein, the lead author of the study and an Associate Professor of Medicine at Harvard commented: "Unless you're Bill Gates you're just one serious illness away from bankruptcy. Most of the medically bankrupt were average Americans who happened to get sick."

---

Not all poor people get Medicaid including some poor kids.

From the US Department of Health and Human Services: Overview of the Uninsured in the United States: An analysis of the 2005 Current Population Survey

According to the Census Bureau's 2005 Current Population Survey (CPS), there were 45.8 million uninsured individuals in 2004, or 15.7% of the civilian non-institutionalized population. Those that lack insurance represent a diverse group.

- The 45.8 million uninsured are more likely to be poor and low income than higher income. Figure 2 shows that over half of the uninsured are below 200% of poverty, with 25% below the poverty line and 28% between 100% and 199% of poverty.(3) That the uninsured are concentrated among lower-income individuals is not surprising, given that low-income individuals are less likely to:

* be working, and if they do work they are less likely to be working full time,
* receive an offer of insurance, and
* be able to afford an offer of coverage.

Not all low-income individuals are eligible for Medicaid. Medicaid eligibility is based on a combination of income and population “category.” The population groups that qualify for Medicaid are generally children, parents of dependent children, pregnant women, the disabled, and the elderly. The income levels at which these groups qualify differs from state to state, and group to group, with coverage of children and pregnant women being available at higher income levels, followed by the disabled and elderly, then parents of dependent children last (though this varies by state). Childless adults who are not disabled or elderly rarely qualify for Medicaid, even at the very lowest income levels.

- The uninsured are more likely to be young. Figure 3 shows 21% of the uninsured are below age 18 and 63% are under age 34. Young adults age 18-34 are disproportionately uninsured relative to their representation in the overall population, while older adults are slightly under-represented relative to the overall population.

---

Poor people struggle more to pay medical bills probably.

From PBS NewsHour: Hospitals Charge Uninsured Patients More, Study Finds

In 2004, U.S. hospitals charged uninsured patients more than two-and-a-half times the amount they charged insurance companies for the same services, the study found. Hospitals also charged uninsured patients more than three times the allowable costs specified by Medicare.

In general, hospitals set prices for services but then negotiate discounts with private insurers. They are also limited as to what they can charge patients covered by Medicare and Medicaid.

The study, which examined hospital charges between 1984 and 2004, found an ever-widening gap between what hospitals charge insured and uninsured patients. In 1984, the uninsured were charged 1.35 times as much as Medicare for hospital services; by 2004 that number had grown to 3.07 times as much.

More than 60 class-action lawsuits have been filed against hospitals over the issue, according to Reuters.

---

Millions of uninsured cost everyone money now but the cost is hidden in insurance payments and taxes. And poor people suffer more and wait to see a doctor because of worries about money. I think a plan with health care for the poor is better because the poor can get preventative health and not wait until so severe problems with big costs. Everyone with insurance pays now and not only with health care for the poor. One difference nowis the poor have worse health and more struggles.


From Families USA: Paying a Premium: The Increased Cost of Care for the Uninsured

This study quantifies, for the first time, the dollar impact on private health insurance premiums when doctors and hospitals provide health care to uninsured people. In 2005, premium costs for family health insurance coverage provided by private employers will include an extra $922 in premiums due to the cost of care for the uninsured; premiums for individual coverage will cost an extra $341.

Nearly 48 million Americans will be uninsured for the entire year in 2005. What happens when some of these 48 million Americans get sick? Research has shown that the uninsured often put off getting care for health problems—or forgo care altogether. When the symptoms can no longer be ignored, the uninsured do see doctors and go to hospitals. Without insurance to pay the tab, the uninsured struggle to pay as much as they can: More than one-third (35 percent) of the total cost of health care services provided to people without health insurance is paid out-of-pocket by the uninsured themselves. - Through this study, we found that the remaining $43 billion is primarily paid by two sources: Roughly one-third is reimbursed by a number of government programs, and two-thirds is paid through higher premiums for people with health insurance.

As the costs of care for the uninsured are added to health insurance premiums that are already rising steeply, more employers can be expected to drop coverage, leaving even more people without insurance. And as more people lose coverage and the cost of their care is added to premiums for the insured, still more employers will drop coverage. It's a vicious circle that will not end until we as a nation take steps to solve the underlying problems.