The number of people who have health insurance and still pay a lot for medical bills has jumped by 60 percent since 2003, a report out today showed. And it is contributing to many bankruptcies, an Augusta attorney said.
The number of underinsured -- people with coverage who still devote a significant portion of their income to health care -- increased from 16 million in 2003 to 25 million last year, the Commonwealth Fund reported. Add that to the uninsured, and it means that 75 million Americans, or 42 percent of all adults younger than 65, lack adequate coverage, said Cathy Schoen, the lead author and senior vice president for research and evaluation at Commonwealth.
The biggest increase in the underinsured came from those whose income is double the federal poverty guidelines, or more than $40,000 a year for a family of four.
"Disturbingly, the percent underinsured in this middle- to higher-income group nearly tripled over the four years," Ms. Schoen said.
Many in this category are paying more for premiums but getting fewer benefits or facing limitations on how much insurance will pay. Fifty-three percent skipped care or didn't fill prescriptions because of cost concerns.
High deductibles were also a culprit -- 26 percent of the underinsured had deductibles of $1,000 or more, said Sara Collins, the co-author of the study published today in the online version of Health Affairs .
"And surprisingly, underinsured adults are also more likely to have high premiums and to spend a large share of their income on premiums," she said.
Nor surprisingly, 45 percent of the underinsured said they had trouble paying medical bills, with some turning to loans or mortgages or piling up debt on their credit cards, Ms. Schoen said.
Augusta bankruptcy attorney Terry Leiden sees it often -- he estimates that about 30 percent of his clients are people who would qualify as underinsured. A major illness knocks them out of work and they start putting those bills on the credit cards or borrow more money, worsening the problem.
"A lot of people don't realize it, but many insurance policies have a lifetime pay and an annual pay (limit)," Mr. Leiden said, and the patient is on the hook after that. One of his clients had a premature infant and ran up $450,000 in medical bills in five months.
"That's the lifetime benefit" limit, he said. "So when that child was 5 months old, the medical insurance on that child ended."
Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.
THE UNDERINSURED
The Commonwealth Fund defines the underinsured as people who have had health insurance throughout the year yet pay 10 percent or more of their income on medical bills. The fastest-rising group is families of four whose incomes were more than $40,000. The underinsured also can include those whose deductible is more than 5 percent of their annual income.
About a quarter of the underinsured had a deductible of $1,000 or more, according to the Commonwealth Fund report.
Comments
Everyone should feel sorry for insurance companies, because
they only make billions and billions annually! The greedy
medical field, including doctors, hospitals, and pharmacies,
will spend thousands to collect a fifty dollar co-pay and it
drives a lot of people into bankruptcy. MCG and University
must pay a fortune for their collection agencies to hound
people over 20.00 dollars
I agree nonumberplease. I say let's stop giving money to the insurance companies, including doctors,hospitals, and pharmacies.
The insurance premiums and the increased co-payments are the problem. I'd like to see you stop giving money to the hospitals, doctors, and pharmacies Patricia and see how you will survive in a medical emergency. The problem won't be solved in our lifetime.
and lets not forget we have to make up the short comings of all our illegal alien friends who cant pay.
Lucky all of you that have health insurance.. Try not having anything .. I have tried to find affordable health insurance that is worthing paying for and no luck!!.. Another point that this article doesn't touch on is that the government health insurance set for old people also leave the provider in a hole therefore the ones that have "true" health insurance are the ones paying for that difference that they need to write off and take a loss on. So we all pay for it even me without health insurance.
Socialized Medicine Now! If it's good enough for the military and President of the United States, it's good enough for all of us.
I was self-employed for 7 years. Successful business with positive cash flow. However, I could not afford a company funded health plan. So, I had an individual plan for my family of four. Premiums went from $450 a month to over $950 per month in just three years! While the quality of that insurance decreased, deductibles increased, and my medical bills accumulated. I had surgery, one of children had surgery, and my wife had a battery of tests run in an attempt to diagnose some odd symptoms. In 6 months time I had met our $5K deductible - made my $950/month premiums - AND - had to pay 20% of co-insurance after my deductible was met. In six months I went from positive cash balance to more than $20K in medical debt. I own my home, my cars, and everything else in my house. We went from being debt-free to debt-laden because of issues well beyond our control. All of this - and I was paying $950/month (that's $11,400 annually) just to have the right to pay an additional $5K annually for deductible just so the insurance company could pick up 80% of what they deemed appropriate to pay. And this was with BC/BS of GA. I had to sell my business and take another job just to get....
reasonable insurance and benefits. The "American Dream" implodes for one family b/c of medical bills. I do not blame the doctors. I blame the businessmen who make these decisions.
rainboot we have the same insurance company.Our dr office co-pay is $40.My prescriptions are $97 a month with insurance.I thought that was high, but my son told me he spends $200 a month on his prescriptions with insurance. He has asthma.Something has to change with our healthcare system.
Before our "benevolent government" became involved with "unhealthy care" there was no crisis. It was pay as you go with a doctor. They cared about their patients and their families. With the hospital, you could go to the administrative office and agree to pay so much a month. Then as always the federal governemnt decided to "help us" ignorant citizens. Civil servants bercame medical experts overnight, they hired professional to help them and those professional hired other professional to help them and the cost of "medical care suddenly had to support another "government program" to lower cost and improve service. The government is right. We are ignorant. Someone has to pay. Government's socialistic programs and insurance company administration has driven the cost of medical care through the roof. As always, follow the money. Everyone who goes to the doctor now is treated, not by their health condition, but by "government guidelines". Whether you are on medicare or not, the doctors and hospitals view everyone by those rules. Hence, question #2 on their forms. Are you 65 or older?
There are instances where if you take the time to talk to your health care provider, you can negotiate a lower cost, just like BCBS. I talked to the front office at Doctors Hosp. and discussed my high deductable and their "negotiated charges" allowed by BCBS. We handled the cost as "private pay" and saved 75% of what would have been paid to the deductable out of pocket. And the Rx "revolution? Suddenly a drug that CVS said my BCBS had saved me $186, but charged me $25 co-pay, is $4 at Kroger, WalMart and Walgreen's. Are these meds coming from Canada? All of the drug stores are Canadian? Did someone actually discover a way to lower cost?
Every medical bill we pay has the hidden cost of some "100 admistrative hands" that handle the paperwork. Just think if we only had to pay the doctor or clinic? MCG bills you $10,000, BCBS allows $1175? Could the average patient not receive the same "negotiated bargain"?
It is impossible to be self-employed anymore unless you are married to someone who works for a big company or the state which provides its employees with health care coverage. The very poor get coverage through Medicaid, the very rich can pay their premiums and bills, but everyone inbetween is screwed. So if you want to start your own business, make sure your spouse has adequate coverage through his or her job. And the government only allows you to deduct a certain percentage of medical expenses each year if you itemize at tax time. I feel so sorry for you and your family, rainboot. My parents had their own business years ago but they couldn't have done it if my dad hadn't gotten medical insurance as a retiree from Bell South. So I understand perfectly.
There are no simple answers. Insurance costs get driven up by lawsuits, but while many lawsuits are frivilous, some are justifiable. That means we cannot take away people's right to sue (though if they have a record of it, or a judge deems it obvioous fluff theh it should be tossed out). I am sure the insurance companies are also jacking up prices to make profit, but that is part of the free market economy. Just like gas prices. Everyone complains, but there is give and take to everything. With socialized medicine we might not get as good as treatment and quality doctors/equipment, etc. Every time a doctor gives you a shot, he/she tosses the needed out and gets a new one, every time they wipe your nose, they toss out the rag, etc. These costs add up, but would we want cheaper coverage and have the doctors reusing such items or cutting corners during operations?
In generations past, people died of things that we now "treat" to an expensive death.
We're living longer, we want and need medicine to fight the ravages of old age, disease and chronic self abuse.... and while we're at it we don't want to be inconvenienced with a wait for care or an older, cheaper drug when we feel entitled to the most costly and up to date innovations yet we all want someone else to pay for it.
It's only going to get worse, folks. Fewer people coming up behind us boomers to take care of the costs when we stop working. I hate to think what it will be like in 20 years. I don't think I will live as long as my parents or grandparents did (all into their mid 80s and 90s). My family spends about $300/mo on our prescriptions with MCG managed care. Everything is $15, $30 or $60 per refill, and the doctors are always wanting to try out the new ones that cost $60 when the $15 drug will work just as well. Not that many of them actually think about how much it costs their patients to get their meds every month.
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