New Studies Highlight the Ugly Problem of Uninsured-and Underinsured-Medical Patients


Most widespread social and economic problems-poverty, famine, homelessness-are not evenly distributed across population for many reasons; the United States is no exception when it comes to this concept. The foreclosure epidemic that has become such a problem over the last year, in fact, has been felt most severely in specific pockets of the country: California, Florida, Ohio, Nevada and Arizona.

The phenomenon of individuals not covered by health insurance is likewise a widespread issue that affects many Americans, and contributes to some of the world's highest health care costs per capita of any nation.

A recent Associated Press article outlined the geographical picture of health insurance coverage across the nation, profiling a new study conducted by the Center for Disease Control and Prevention that found that the Southwest features the greatest concentration of uninsured individuals (the Southwest includes Arizona, New Mexico, Texas and Oklahoma). Conversely, New England owns the title of the region with the most individuals insured.

The CDC study found that 30 percent of non-elderly adults as well as 18 percent of children were uninsured in the Southwest, a fact that one expert unaffiliated with the study believes may be attributed to the types of jobs that are predominant in the Southwest, including service jobs and construction jobs, many of which do not typically offer good health benefits.

The study focused on regions primarily because it was only able to collect a substantial baseline number of respondents from 41 states. Of those states that had enough respondents to provide accurate numbers, Oklahoma- in the Southwest region--had the highest rate of uninsured individuals at 33 percent. No surprise, the states with the lowest percentages of uninsured individuals came from other regions: Hawai'i and Massachusetts each boast a low 9.5 percent.

In the New England region, 11 percent of non-elderly adults were uninsured, and a very low 4 percent of children. The regions of the Great Plains, Great Lakes, and the Northeast each had similar percentages, with rates of 14-15 percent for adults and 6-7 percent for children. The nation's second-worst region for adults after the Southwest was the Southeast, which featured 23 percent of adults uninsured.

The overall percentage for the nation, which combined the percentages for adults and children for a total number of individuals under 65, was nearly 17 percent.

In raw numbers, that translates to an estimated 54 million Americans without insurance during at least part of last year, with an estimated 31 million without insurance for more than one year.

Similarly, not just uninsured patients are a major issue, but underinsured patients as well. These are individuals who may have coverage for major items through work or school, but who still cannot afford routine checkups or lower-urgency treatments. In this, underinsured patients are in the same boat as the uninsured: their preventive action on maintaining good health and controlling chronic conditions is minimal, and can often lead to major problems down the road entailing drastic-and expensive-treatments.

A study by the Commonwealth Fund estimates that around 14 percent of the adult population in America is underinsured, which leads to some startling health and financial problems. The percentage of adults under 65 who went without needed care due to lack of insurance was 68 percent, but the percentage of those in the same category who were underinsured was 53 percent.

Similarly, medical debt has become a huge problem, and lack of adequate coverage is a main culprit in this problem. While 51 percent of uninsured adults had outstanding debt due to medical bills, a similar number (45 percent) of underinsured individuals had these debts.

It's a good reminder that insurance companies only make money when they are able to limit compensation, and they often do this preemptively by limiting coverage. Those expensive treatments and medications that are draining the pockets of many uninsured and underinsured patients across the country are more bills that the insurance company doesn't have to pay-and that much more they can add to their bottom lines.

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