Report says millions of U.S. uninsured skip needed treatment

Stat house
May 2005

Report says millions of U.S. uninsured skip needed treatment
Global poverty by the numbers

Report says millions of U.S. uninsured
skip needed treatment
A new analysis of government data shows that millions of uninsured adults in the U.S. suffer with chronic illness and have medical needs that are unmet. Nearly half (45 percent) of non-elderly, uninsured adults report having one or more chronic health problems. More than 15 million uninsured adults in the U.S. have diabetes, heart disease, asthma, or other chronic conditions. The analysis documents that millions of these chronically ill adults forgo needed medical care or prescription drugs due to cost, leaving them at serious risk for increased health problems.

“Uninsured Americans with Chronic Health Conditions: Key Findings from the National Health Interview Survey” was released on May 2 by the Robert Wood Johnson Foundation (RWJF) to kick-off Cover the Uninsured Week, the largest nonpartisan campaign in history to focus attention on the need to secure reliable, affordable health coverage for all Americans. Some of the most influential organizations in the country are cosponsoring the Week, May 1 - 8, 2005. The effort is co-chaired by Presidents Gerald Ford and Jimmy Carter and endorsed by nine former U.S. Surgeons General and U.S. Secretaries of Health and Human Services.

“Being uninsured carries serious health consequences,” said C. Everett Koop, M.D., a former Surgeon General of the United States appointed by President Reagan. “Americans who are uninsured have the same medical conditions that insured Americans have—high blood pressure, diabetes, cancer, and so forth. But because they do not have health coverage, they are not able to get the medical care they need. They don't see their doctor as early as do patients with insurance. To be blunt, uninsured patients are more likely to die than their insured counterparts with the same diagnosis. ”

The report was prepared for RWJF by researchers at the University of Maryland, Baltimore County and The Urban Institute. Additional findings include:

• Almost half (49 percent) of uninsured adults with chronic conditions forgo needed medical care or prescription drugs due to cost. Uninsured adults with chronic conditions were 4.5 times as likely as their insured counterparts to report an unmet need for medical care or prescription drugs.

• Many uninsured adults with chronic illness do not have a usual source of health care. Uninsured adults with chronic conditions were more than seven times as likely as insured adults with chronic conditions to lack a usual source of health care.

• Uninsured adults with chronic conditions are less likely to visit a health professional than their insured counterparts. More than one in four (27 percent) uninsured adults with chronic conditions reported no visits to a health professional in the past year, compared to about one in 14 (seven percent) insured adults.

• Despite having fewer contacts with the health care system, uninsured adults with chronic conditions still face large out-of-pocket expenditures for their care. More than one in five (21 percent) uninsured adults with a chronic condition report spending at least $2,000 out of pocket on medical care in the 12 months prior to the survey.

The report uses data from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and is derived from an analysis of the 2003 National Health Interview Survey (NHIS), the most recent available. NHIS is a survey of the U.S. population looking at health status, access to care, use of health care services, and economic and social characteristics.

On May 2, the Robert Wood Johnson Foundation released results of a new national public opinion poll showing strong support for action on behalf of America’s uninsured, and improving health coverage in general. Conducted by Public Opinion Strategies in Alexandria, Va., the poll found that nearly three out of four registered voters surveyed (73 percent) are concerned about losing their own health care coverage. Voters say that improving access to affordable health insurance and coverage should be a top-tier issue for President Bush and Congress.

Respondents were asked, “In addition to concerns about terrorism, national security, and the situation in Iraq, which ONE of the following issues do you believe should be the next highest priority for Congress and the President?”

The top issue for voters surveyed was Social Security/Medicare (27 percent), followed by ‘access to affordable health insurance and coverage’ (24 percent), and in third, ‘jobs and the economy’ (23 percent). The poll was conducted March 29-31, 2005, and has a margin of error of +/- 3.46 percent.

“Poll after poll shows that the American people want our leaders to make affordable and stable health coverage for all Americans a top priority,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation. “The situation is truly puzzling. Despite popular support for action on health coverage, our leaders have yet to truly focus on solving this problem.”

During "Cover the Uninsured Week," hundreds of health fairs will be held nationwide to provide free medical screenings and information to those without insurance. Volunteers will help enroll uninsured adults and children in public programs that provide free or low-cost coverage to those who are eligible. State-specific guides aimed at helping individuals find out about local health coverage options will be distributed at events. Business seminars will provide opportunities for small business owners to discuss ways to provide affordable health plans for their employees. Special coverage-oriented educational forums will take place on campuses nationwide. Rabbis, pastors, priests, and imans throughout the nation will be talking about this issue and getting congregants involved in efforts to help people who are uninsured.

For more:
USCCB's role in Cover the Uninsured Week

More Statistics on Uninsured Adults who Report Select Chronic Conditions (See more at www.CoverTheUninsuredWeek.org):

Diabetes
• More than one in seven (15 percent) non-elderly adults in the U.S. who report having diabetes are uninsured. That means 1.2 million adults in America report having diabetes, but have no health coverage.

• Nearly one-third (32 percent) of uninsured adults with diabetes did not have a single source of management for their condition. More than three out of four uninsured adults who report having diabetes did not have a health professional examine their feet, and three out of five (60 percent) did not have a dilated eye exam in the past year.

Heart Disease
• More than one in eight (13 percent) non-elderly adults in the U.S. who report having heart disease are uninsured. That means than 1.7 million adults in America report having heart disease, but have no health coverage.

• One in four (25 percent) uninsured adults with heart disease reported no visits to health professionals in the past year, compared with more than one in 16 (six percent) insured adults with heart disease.

Asthma
• More than one in six (18 percent) non-elderly adults in the U.S. who report having asthma are uninsured. That means 2 million adults in America report having asthma, but have no health coverage.

• More than one in three (36 percent) uninsured adults with asthma lacked a usual source for health care; uninsured adults with asthma were seven times as likely as their insured counterparts to lack a usual source for care.

Arthritis-Related Conditions
• Almost one in eight (12 percent) non-elderly adults in the U.S. who report having arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia are uninsured. That means 3.6 million adults in America report having arthritisrelated conditions, but have no health coverage.

• More than half (59 percent) of uninsured adults with arthritis-related conditions have an unmet need for either medical care or prescription drugs. Uninsured adults with arthritis are 4.5 times as likely as insured adults with arthritis to have an unmet need for medical care or prescription drugs.

High Cholesterol
• More than one in 10 (11 percent) non-elderly adults in the U.S. who report having high cholesterol are uninsured. That means 3.3 million adults in America report having high cholesterol, but have no health coverage.

• Uninsured adults with high cholesterol face large out-of-pocket expenditures for their care. Despite having fewer contacts with the health care system, more than one in four (28 percent) uninsured adults with high cholesterol report spending at least $2,000 out of pocket on medical care in the 12 months prior to the survey.

Hypertension
• One in seven (14 percent) non-elderly adults in the U.S. who report having hypertension are uninsured. That means that 4 million adults in America report having hypertension, but have no health coverage.

• Three in 10 (30 percent) uninsured adults with hypertension lack a usual source of health care, compared with just three in 100 (3 percent) of their insured counterparts.

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