Lack of health care and prescription drug insurance in the United States: a serious public health problem

Lack of health care and prescription drug insurance in the United States: a serious public health problem

General statistics

Sources: "Health Care Coverage in America: Understanding the Issues and Proposed Solutions." Alliance for Health Reform. Cover the Uninsured Week 2004.
http://covertheuninsuredweek.org/materials/files/IssuesGuide.pdf

"Health Insurance Coverage in America: 2003 Data Update."  Kaiser Commission on Medicaid and the Uninsured. November 2004.
www.kff.org/uninsured/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=49550

"Income Poverty, and Health Insurance Coverage in the United States: 2003."  US Census Bureau. Table 5.
www.census.gov/prod/2004pubs/p60-226.pdf

  • 45 million Americans were uninsured in 2003, up from 43.6 million in 2002.
  • More than eight out of 10 people who are uninsured come from working families.
  • 8.4 million children are uninsured.
  • More than one in five adults ages 18 to 64 was uninsured in 2003. 11.4 percent of children under 18 were without insurance.
  • More than 29 million of the uninsured in 2003 had household incomes of $25,000 or more, compared with 15.3 million in households earning less.

State-specific statistics

Sources: "Characteristics of the Uninsured: A View from the States." States Health Access Data Assistance Center, University of Minnesota. May 2004.
http://covertheuninsuredweek.org/media/research/brffs.pdf

"Rate of Nonelderly Uninsured by Age, state data 2002-2003, U.S. 2003."   Kaiser Family Foundation State Health Facts.
www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Health+Coverage+%26+Uninsured&subcategory=Nonelderly+Uninsured&topic=Rate+by+Age

  • Between 2002 and 2003, states with the highest percentages of uninsured nonelderly adults include Texas (31%), New Mexico (30%), Louisiana (26%), and Alaska and Oklahoma (25%).
  • States with the lowest percentages of uninsured adults include Minnesota (7.8%), Hawaii (10.2%), Delaware (10.3%) and Massachusetts (10.7%).

The uninsured and prescription medicines

Sources: Health Care Coverage in America: Understanding the Issues and Proposed Solutions, Cover the Uninsured Week.

"Health Insurance Survey."   Kaiser Family Foundation. October 2004. Chart 1.
www.kff.org/insurance/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=48503

  • Uninsured children are more than three times less likely to get a needed prescription drug, as compared with children with insurance.
  • In 2003, 37 percent of the uninsured did not fill a prescription because of cost.

Source: "The Uninsured: A Primer."
Kaiser Commission on Medicaid and the Uninsured. December 2003.
www.kff.org/uninsured/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=29345
According to a health insurance survey of insured and uninsured respondents between the ages of 18 and 64, 81 percent of those polled said that they would feel vulnerable to high medical bills, rather than well-protected by their insurance, if their health care plan did not pay for prescription drugs.

Minority health insurance coverage

Sources: "Health Care Coverage in America: Understanding the Issues and Proposed Solutions." Alliance for Health Reform. Cover the Uninsured Week 2004. http://covertheuninsuredweek.org/materials/files/IssuesGuide.pdf.

"Characteristics of the Uninsured: A View from the States." States Health Access  Data Assistance Center, University of Minnesota. May 2004.

"Health Insurance Coverage in America: 2003 Data Update."   Kaiser Commission on Medicaid and the Uninsured. November 2004. http://www.kff.org/uninsured/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=49550

  • Minorities make up 34 percent of the nonelderly population, but account for more than half (52%) of the uninsured.
  • Hispanics are more likely to be uninsured than other ethnic groups.
  • In 2003, 41.9 percent of nonelderly Hispanic adults were uninsured, compared with 33.3 percent of American Indians and Aleutian Eskimos, 24.5 percent of blacks, 23.2 percent of Asian and South Pacific Islanders, and 15 percent of non-Hispanic whites.
  • Also in 2003, 21.9 percent of Hispanic children were uninsured, followed by 19.1 percent of American Indian and Aleutian Eskimo children, 14.9 percent of black children, 12.6 percent of Asian and South Pacific Islander children and 7.7 percent of non-Hispanic white children.
  • 35.4 percent of working Hispanic adults are uninsured, compared with 18.4 percent of working black and 11.3 percent of working white adults.
  • 20.6 percent of uninsured black adults are unable to get needed medical care, compared with 18.9 percent of uninsured white and 16.5 percent of uninsured Hispanic adults.

Children's health care insurance coverage

Sources: "In Focus: Children's Care and Coverage:  Where Do We Go from Here?" Alliance for Health Reform. October 1, 2004. www.allhealth.org/.

""Income Poverty, and Health Insurance Coverage in the United States: 2003."   US Census Bureau. Table 5.
www.census.gov/prod/2004pubs/p60-226.pdf

"Health Insurance Coverage in America: 2003 Data Update."   Kaiser Commission on Medicaid and the Uninsured. November 2004.
www.kff.org/uninsured/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=49550

"Rate of Nonelderly Uninsured by Age, state data 2002-2003, U.S. 2003."  Kaiser Family Foundation State Health Facts.
www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Health+Coverage+%26+Uninsured&subcategory=Nonelderly+Uninsured&topic=Rate+by+Age

"A Shared Destiny: Effects of Uninsurance on Individuals, Families and Communities."  Institute of Medicine. March 2003: 1-8.

  • Despite vigorous efforts in recent years to insure more children, the number of children without coverage is stable, dropping only .02 percentage points between 2002 and 2003.
  • Public coverage of children has been on the rise - up 1.7 million children between 2002 and 2003.
  • Employer-sponsored coverage is shrinking - dropping from 62 percent in 2000 to 57 percent by 2003.
  • Even when children have coverage, they may not get all the care they need.
  • States with the highest percentages of uninsured children (18 and under) include Texas (22%) and Nevada (19%).
  • Half of all uninsured children did not see a doctor in 2003.
  • Compared to children with insurance, uninsured children are:
  • Just one-sixth as likely to have a usual site of health care (4% vs. 24%).
  • More than five times as likely to have an unmet need for medical care each year.
  • At least 70 percent more likely to go without care for common childhood conditions such as asthma, ear infections and sore throats

Why Americans go without health care

Source: Health Care Coverage in America: Understanding the Issues and Proposed Solutions, Cover the Uninsured Week.

  • A Commonwealth Fund study found that the number of uninsured, low-income children would decline by nearly 40 percent and the number of uninsured adults would decline by more than 25 percent if every person with public or private insurance at the beginning of a given year was able to retain it through the next 12 months.
  • In 2001, more than one out of four of the nation's uninsured (nearly 10 million people) either worked for a firm with 500 or more employees or were dependents of someone who worked for a 500+ employee firm.
  • Jobs held by the working uninsured tend to be in service industries and in smaller firms, where employees are less likely to be offered coverage or where coverage is unaffordable.
  • The overwhelming majority of the uninsured are from families actively in the labor force.
  • Americans with incomes below the federal poverty level are most likely to lack coverage-30.4 percent were uninsured in 2002 vs. 15.2 percent of the total population. For 2004, the poverty level was $18,850 for a family of four in every state except Alaska and Hawaii, where the figure was higher.
  • Barriers that prevent people from joining public or private insurance plans include waiting periods before a worker can sign up for an employer plan, and complex enrollment and renewal procedures that discourage people from applying for public insurance and keeping it if they get it.

Consequences of going without health care

Sources: Health Care Coverage in America: Understanding the Issues and Proposed Solutions, Cover the Uninsured Week.

"The Economic Downturn and Changes in Health Insurance Coverage, 2000-2003."   Kaiser Commission on Medicaid and the Uninsured. May 2004: Release.

  • Uninsured U.S. residents will incur nearly $41 billion in uncompensated care in 2004.
  • Not having health insurance threatens the financial security of families.
  • Because families with at least one uninsured member tend to have lower incomes than do fully insured families, as well as very few assets, they generally have fewer financial resources to help cope with higher medical expenses.
  • Of those lacking coverage, 39 percent who also have medical bill problems or accrued medical debt reported that they struggled to pay for expenses such as food, rent or heat.
  • Half (53%) said they were forced to use most or all of their savings to pay medical bills. One out of five said they had run up large credit card debts or had to take out a loan against their home to pay medical expenses.
  • An estimated 18,000 adults die each year because they are uninsured and can't get appropriate health care, according to the federally chartered Institute of Medicine (IOM), which produced a series of reports on the consequences of not having health coverage.
  • The IOM noted that people uninsured for at least a year report being in worse health than those uninsured for a shorter period.
  • Some 20 percent of those without coverage for at least a year said their health was poor or fair, compared with 14 percent of those uninsured for less than a year.
  • But even those uninsured for a short period of time experience problems getting access to care.
  • Hospitalized patients without health insurance receive fewer needed services and worse quality care, and have a greater risk of dying in the hospital or shortly after discharge than patients with insurance.

Sources:
"In Focus: Children's Care and Coverage:  Where Do We Go from Here?"
Alliance for Health Reform. October 1, 2004.
www.allhealth.org/.

"Health Care Coverage in America: Understanding the Issues and Proposed Solutions."  Alliance for Health Reform. Cover the Uninsured Week 2004.
http://covertheuninsuredweek.org/materials/files/IssuesGuide.pdf.

"Characteristics of the Uninsured: A View from the States."
States Health Access Data Assistance Center, University of Minnesota. May 2004.
 http://covertheuninsuredweek.org/media/research/brffs.pdf

"Health Insurance Coverage in America: 2003 Data Update." 
Kaiser Commission on Medicaid and the Uninsured. November 2004.
www.kff.org/uninsured/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=49550

"Income Poverty and Health Insurance Coverage in the United States: 2003." 
US Census Bureau. Table 5.
www.census.gov/prod/2004pubs/p60-226.pdf

"Rate of Nonelderly Uninsured by Age, state data 2002-2003, U.S. 2003."
Kaiser Family Foundation State Health Facts.  www.statehealthfacts.org/cgi-bin/healthfacts.cgi?action=compare&category=Health+Coverage+%26+Uninsured&subcategory=Nonelderly+Uninsured&topic=Rate+by+Age  

"Health Insurance Survey."
Kaiser Family Foundation. October 2004. Chart 1.
www.kff.org/insurance/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=48503

"A Shared Destiny: Effects of Uninsurance on Individuals, Families and Communities."  Institute of Medicine. March 2003: 1-8.

"The Economic Downturn and Changes in Health Insurance Coverage, 2000-2003." Kaiser Commission on Medicaid and the Uninsured. May 2004: Release.

Posted: January 2005


View comments

Hide
(web3)