Sick, Uninsured and Drowning in Debt
U.S. Health Care System Failing Millions of Americans
Oct 16, 2008
According to the Commonwealth Fund, a private foundation that works to improving the American health care system, 61.4 million of the 177 million adults in the U.S. in 2007 had adequate health insurance coverage and no problem accessing the health care system. The other two-thirds weren’t so lucky.
Between 2000 and 2007, nearly 9 million adults lost their health insurance, leaving about one-quarter (28%) uninsured at some point during the past year. That’s a jump from 38 million to around 50 million. The majority of the uninsured adults (58%) were part of working families, with at least one person employed full-time. Only 29% of the uninsured adults lived in families in which no one worked. In fact, 41% of all uninsured adults worked full-time.
The Fund also reports that the number of underinsured (those whose health coverage doesn’t adequately protect them from high medical costs) also climbed substantially in recent years. For example, in 2003 there were 16 million underinsured adults, but by 2007 that number was 25 million - due to higher premiums, deductibles, and co-pays.
Harder for Poor to Access Health Care
Although the failures of the health care system have affected Americans from all segments of the population, the poor have been hit the hardest. According to the Fund, low-income families (under $20,000/year) have the highest uninsured rates, with half of the adults either currently without health insurance or without it at some point in the past year.
However, the gap narrowed between low-income families and moderate-income families ($20,000-$34,999/year). In 2007, 41% of the adults in moderate-income families were either currently without health insurance or had been in the past year. That’s a jump from 28% in 2001 to 35% in 2003 to the 2007 levels.
Even middle-income families ($35,000-$59,999/year) and high-income families ($60,000 or more/year) saw increases of 4-5% in the number of uninsured adults, although their totals continue to represent only a small percentage of those populations.
Health Care at Risk
Uninsured adults often do not receive adequate health care. Because of high medical costs, they’re less likely to have their blood pressure and cholesterol checked, they delay preventative screening tests (such as cancer tests), and they postpone dental care. The Fund reports that more than 70% of adults with gaps in their health insurance could not afford needed health care, which was up from about 50% in 2001.
Given such trends it’s not surprising that uninsured and underinsured adults with chronic conditions not only fail to take necessary medications, but are also more likely to visit an emergency room because of those conditions, putting more stress on an already over-taxed system. According to the Fund, at least one-third of uninsured or underinsured adults headed to the ER or stayed overnight at a hospital, compared to 19 percent of adults with adequate insurance.
Medical Debt Meltdown
At the root of this lack of adequate health care is, of course, money. In 2007, one-third of all adults (both insured and uninsured) spent at least 10 percent of their incomes on health insurance and health care, a 21% increase from 2001. Low-income families made the greatest leap, with 53% of all adults in that group spending 10% or more on medical expenses, an increase of over 50%.
And the effects are being felt across the country. About 41% percent of U.S. adults - 72 million people - struggle to pay medical bills, compared to 58 million in 2005. That’s a startling 34% increase. As a result, not only have families had to forego necessary treatments, but their mounting debts can lead to bankruptcy and financial ruin. If this trend continues, few in the U.S will be able to afford health care - except, perhaps, members of Congress and the wealthiest of the wealthy.
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