St Marks Hospitals

The Rising Cost of Medical Bills

November 12, 2009 – 11:31 am

A survey by Commonwealth Fund questioned 3456 Americans aged from 19 to 64 and found that health care costs increase more rapidly than family income does. This creates serious health problems in addition to economic decline. The survey analyzed and compared figures during the period from 2001 to 2007.

The medical bills survey reported that 2/3 of people at a working age were either uninsured or underinsured in 2007. Thus, they did not receive adequate health treatment. Two out of five questioned adults were unable to pay medical bills and faced medical debt, while in 2005 the number of people in this category was lower - one out of three.

In 2007 there were 28% working and uninsured people, while in 2001 it was much lower - 21%. Even those with insurance were unable to afford proper and on-time health care with 61% of insured facing medical debt. However, those with proper insurance covering all their medical costs increased from 9% in 2003 to 14% in 2007.

In 2007, 29% of surveyed people had to put aside common spending, such as food, heating, and rent, to be able to pay for health care, about 30% faced credit card debt, 39% exhausted all their spending to somehow cover medical bills.

The survey found that health care spending accounts for a great percentage of overall spending with middle-income families spending 53% of income to cover medical bills in 2007, which is twice as much as 26% in 2001.

Commonwealth Fund looked at different overall income group families and found that 50% of those earning less than $20,000 were uninsured, which is only 1% increase compared to 2001. Those people earning in the range of $20,000 to $40000 were 41% uninsured, which is a significant increase compared to 28% in 2001. Those earning from $40,000 to $60,000 were 18% uninsured, compared to 13% in 2001, and those earning more than $60000 were 8% uninsured, compared to 4%.

Overall, the survey shows how critical situation with the health care system is: there are lots of families who can not afford adequate healthcare and health insurance coverage even if they work and pay insurance bills they still experience huge difficulties with paying medical bills. The survey also found that there is a very small difference among low and middle income families, with most of them unable to afford healthcare.

It seems, that the basic health care is luxury and not everyone can afford it.

Health officials’ response to this survey was that universal health insurance coverage will significantly improve health care system and will allow most of working adults to receive adequate medical assistance.

One of Five Working-Age Adults Is Paying Off Medical Debt

Nearly Sixty Percent of Uninsured Adults with Chronic Illness Skip Pills Due to Cost, Many End Up in ER or Hospital

New York, NY, April 26th, 2006—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, according to a new report from The Commonwealth Fund, Gaps in Health Insurance: An All-American Problem, prepared for the Fund’s Commission on a High Performance Health System.

Lower-income adults were still the most likely to be uninsured. The vast majority of the uninsured are in working families: of the estimated 48 million working-age Americans uninsured during the year, 67% were in families where at least one person was working full time.
biennial 1

“The jump in uninsured among those with modest incomes is alarming, particularly at a time when our economy has been improving,” said Commonwealth Fund president and study co-author Karen Davis. “If we don’t act soon to expand coverage to the uninsured, the health of the U.S. population, the productivity of our workforce, and our economy are at risk.”

The study finds a startling number of adults are now grappling with medical debt—unpaid medical bills. One of five (21%) adults, including insured and uninsured, currently has medical debt they are paying off over time, and one-third (34%) either had medical bill problems in the past year or were paying off accrued medical debt. The survey of adults ages 19 to 64 reveals that medical debt is not an issue for the uninsured alone. Nearly two-thirds (62%) of adults with medical bills or debt problems said that they or their family member were insured when they incurred the debt.

The survey looked at the medical consequences families face when they go without health care coverage. Researchers found that an alarmingly high proportion—59 percent—of adults with a time uninsured in the past year with chronic illnesses, such as diabetes and asthma, went without or skipped their medications because they couldn’t afford them. This same group was also more likely to go to an emergency room or hospital for chronic conditions than those with insurance. One-third (35%) of uninsured adults with chronic conditions visited an ER, or stayed in the hospital overnight, or did both, compared to 16% of those insured all year with a chronic condition.

Americans without health insurance were also more likely to go without recommended cancer, cholesterol, and blood pressure screenings. According to the report, only 18% of adults ages 50 to 64 who were uninsured at the time of the survey had a colon cancer screening in the past five years compared to 56% of insured adults. Similarly, fewer than half (48%) of women ages 50 to 64 who were uninsured at the time of the survey had a mammogram in the past two years, compared to three-fourths of insured women. An analysis of the health care experiences of adults released today by the Robert Wood Johnson Foundation confirms similar trends in every state. Information on this new study is available at www.covertheuninsured.org.
biennial 2

“These findings paint a disturbing picture of the day-to-day impact of being uninsured on the physical as well as financial health of millions of Americans,” said Sara Collins, Commonwealth Fund senior program officer, and the study’s lead author. “The uninsured are more likely to go without preventive care or screening tests that could prevent more serious and costly health problems. For an uninsured person who is unlucky enough to get sick, it is easy to see how quickly they can fall into a downward spiral of debt, forgone care, and poorer health.”

Researchers also found that being uninsured exacerbates existing problems with efficiency in health care. The uninsured are less likely than the insured to have a regular doctor, and are more likely to endure the effects of our fragmented health care system as they move from one place of care to another. Nearly one-quarter (23%) of adults who are currently uninsured or had a time uninsured reported that test results or records were not available at the time of a doctor’s appointment, compared with 15% of insured adults. Nearly one-fifth (19%) of uninsured adults had duplicate tests ordered, compared with 10 percent of insured adults.

Other key survey findings include:

* More than two of five (44%) of all working-age adults with medical debt reported it was $2,000 or more.
* More than four of five (82%) uninsured adults had been uninsured for one year or more.
* 63% of working uninsured adults were solo business owners or were working for firms with fewer than 100 employees.
* 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 bill, and two of five were unable to pay for basic necessities like food, heat, or rent because of medical bills.
* Only 35% of uninsured adults had a dental exam in the past year, half the rate of adults with medical insurance.
* Just 41% of uninsured adults had a regular doctor or other health care professional compared with 86% of insured adults.
* 37% of all working-age adults reported cost-related problems or delays in getting medical care. The uninsured are particularly vulnerable, with 60% reporting problems or delays in getting medical care.

Methodology
The Commonwealth Fund Biennial Health Insurance Survey was conducted by Princeton Survey Research Associates International from August 18, 2005, through January 5, 2006. The survey consisted of 25-minute telephone interviews in either English or Spanish and was conducted among a random, nationally representative sample of 4,350 adults age 19 and older living in the continental United States. This analysis focuses on the U.S. population ages 19 to 64.