Wednesday, August 13, 2008

New study on the uninsured

This month there was a new study trying to document the rate of chronic illness among the uninsured. Often some policymakers try to argue that people without insurance tend to be young and healthy and just don’t want to spend the money on insurance.

Some of us know better.

The study seems to confirm it. It found that roughly 1 out of 3 people without insurance have a diagnosed chronic illness. The study is based on numbers from 2004 when there were only 34 million uninsured. Now the number is up to an estimated 47 million.

The study’s abstract gives examples of chronic health problems like high blood pressure, diabetes and COPD. I’m not clear from reading it if they asked about these diseases specifically, or if they asked the question in a more general matter. If they asked the question in a disease specific manner, then of course all of us with chronic and rare diseases not on the list would have been missed.

And some have argued (and I would tend to agree) that these numbers don’t reflect people who are not getting diagnosed because they don’t see a doctor regularly or have any continuity of care. We see this a lot in the HPS community where so many families are already facing a lot of socio/economic challenges before they know they’re affected by HPS.

But I’ll up the ante.

The problem of the uninsured is big and needs to be addressed. If not, these folks will be sicker, cost more and end up disabled or dead sooner. But the problems with lack of coverage extend beyond the uninsured. As companies (like mine) cut back on expenses they’re being forced to offer policies that cover less.

Yes, I have insurance, but my chronic health condition is costing me, on average, $500 a month if I don’t see a doctor and nothing goes wrong. That’s just co-pays for medicine, ostomy and CPAP supplies. Add in a few doctor visits at $20 a co-pay and $40 cab fare (if I’m lucky) and it can get worse much faster.

I know several HPS’ers who face the dilemma of which symptoms they’re going to live with and which they’re going to try to treat. If they take a GI medication, for example, that can easily cost thousands then they might have to forego blood pressure medication etc.

Everyone has the election issues that are close to their hearts. This one is one of mine.

This is a link to the abstract in the Annals of Internal Medicine:
http://www.annals.org/cgi/content/abstract/149/3/170

And this is a link to a great article the New York Times did.
http://www.nytimes.com/2008/08/05/business/05health.html?_r=3&scp=1&sq=Uninsured&st=cse&oref=slogin&oref=slogin&oref=slogin

1 comment:

Care said...

Great post Heather, and this is an issue close to my heart as well. I am fortunate to have insurance, but even with insurance I spent on average 10-15% of my gross income on medical expenses, mostly due to Ethan's meds and specialists, and every year that percentage goes up as the cost of insurance, copays, and deductibles rise, and the coverage levels go down. On the other hand, I can't imagine what we would do without insurance. My Aunt, who died earlier this year, had multiple chronic medical issues, but could not obtain insurance. It's hard not to think about what might have been, had she been able to afford better medical care.