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eridani

(51,907 posts)
Mon Dec 1, 2014, 06:30 PM Dec 2014

Cost Still a Barrier Between Americans and Medical Care

http://www.gallup.com/poll/179774/cost-barrier-americans-medical-care.aspx

One in three Americans say they have put off getting medical treatment that they or their family members need because of cost. Although this percentage is in line with the roughly 30% figures seen in recent years, it is among the highest readings in the 14-year history of Gallup asking the question.

Last year, many hoped that the opening of the government healthcare exchanges and the resulting increase in the number of Americans with health insurance would enable more people to seek medical treatment. But, despite a drop in the uninsured rate, a slightly higher percentage of Americans than in previous years report having put off medical treatment, suggesting that the Affordable Care Act has not immediately affected this measure.

The percentage of Americans with private health insurance who report putting off medical treatment because of cost has increased from 25% in 2013 to 34% in 2014.

This year, 22% of Americans say they have put off medical treatment for a "very" or "somewhat serious" condition.

One of the goals of opening the government exchanges was to enable more Americans to get health insurance to help cover the costs of needed medical treatments. While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost
.

Underinsurance Remains Big Problem Under Obama Health Law

http://www.nytimes.com/2014/12/02/upshot/underinsurance-remains-big-problem-under-obama-health-law.html

The A.C.A. has not done as much as many had hoped it would to reduce underinsurance. In fact, it may be helping to spread it. And proposed modifications to the law, like those that would introduce a new tier of “copper” plans in addition to bronze, silver, gold and platinum, might make underinsurance worse.

The point of having insurance is to be able to get care when you need it, without too large a financial burden. Underinsured Americans are not receiving this benefit, though. They can’t get the care they need. Twenty-seven percent of adults with a deductible large enough to render them underinsured didn’t see the doctor when they were sick; 23 percent didn’t get a preventive care test; 29 percent skipped a test, treatment or follow-up appointment; and 22 percent didn’t see a specialist to whom they were referred. Forty percent of them had at least one of these cost-related access problems.

These are people who had private health insurance for the full year. They are not the uninsured.

In the quest for universal coverage, it’s important that we not lose sight of “coverage” in order to achieve “universal.” The point of improving access is, after all, to make sure that people can get, and afford, care when they need it.


Comment by Don McCanne of PNHP: Health care reform should have eliminated underinsurance, not create more of it. The private insurance industry will not fix this problem but only compound it as it strives to keep its premiums competitive.

We need to replace the private insurers with our own single payer program. For some, Medicare is also underinsurance. We need to fix that and then provide it to everyone.

(Posted as a comment on the NYT website as a response to Aaron Carroll’s article.)
22 replies = new reply since forum marked as read
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Cost Still a Barrier Between Americans and Medical Care (Original Post) eridani Dec 2014 OP
I've recently learned an aquaintance has a rare disorder that requires uncovered drugs. Vinca Dec 2014 #1
So it is a brand name drug and their plan doesnt cover brand names? NoJusticeNoPeace Dec 2014 #3
ACA does NOT allow UNDER-INSURANCE unless they are referring to deductibles and copays NoJusticeNoPeace Dec 2014 #2
There are millions who have gotten insurance, BUT SoCalDem Dec 2014 #4
Agree, which is why ACA is an improvement but is still FAR FAR FAR from what we need NoJusticeNoPeace Dec 2014 #5
If it is? zipplewrath Dec 2014 #17
Single payer would cost even more for people yeoman6987 Dec 2014 #7
Ten fix medicare, do what Canada does... NoJusticeNoPeace Dec 2014 #8
Canada also pays 60 percent in taxes...everyone yeoman6987 Dec 2014 #9
People in Canada do just fine for the most part, and I am not sure about your stats NoJusticeNoPeace Dec 2014 #10
I would rather pay more in taxes than the $25k our of pocket non-covered items Paula Sims Dec 2014 #13
Medicare isn't single payer, "Medicare for all" is mostly marketing to give folks a familiar TheKentuckian Dec 2014 #11
I've had insurance for years and don't go to the doctor because of co-pays. alarimer Dec 2014 #16
70% of those who file for bankruptcy due to medical reasons have insurance eridani Dec 2014 #18
Large yearly deductibles make insurance worthless. L0oniX Dec 2014 #6
Not worthless, what would you rather have over your head NoJusticeNoPeace Dec 2014 #12
who gives a few years KT2000 Dec 2014 #14
You're destroying NJNP's imagination. L0oniX Dec 2014 #20
please, what does NJNP mean? I'm unclear. thx irisblue Dec 2014 #21
Yea ...I would be finished paying the $5000 in about ...when I'm dead. L0oniX Dec 2014 #19
It seems to me that LiberalElite Dec 2014 #22
Thank you for this. Le Taz Hot Dec 2014 #15

Vinca

(50,522 posts)
1. I've recently learned an aquaintance has a rare disorder that requires uncovered drugs.
Mon Dec 1, 2014, 06:33 PM
Dec 2014

To the tune of $250 a week. They're having trouble making the rent. Worse yet, the prognosis is pretty poor and she's a young woman with kids. It's a shame we don't live in a country that makes life easier for people rather than harder.

NoJusticeNoPeace

(5,018 posts)
3. So it is a brand name drug and their plan doesnt cover brand names?
Mon Dec 1, 2014, 06:38 PM
Dec 2014

This is just another example of us allowing for profit companies to make the rules, while ACA changes the rules in our favor in some areas, the real change needed is Medicare for all.

If the entire country went on a general strike demanding

a. medicare for all

b. $15 minimum wage nationwide

c. mandatory vacation and sick leave and maternity paid leave

d. lift the cop soc sec

e. raise taxes on the wealthy and corps and punish those companies that dont manufacture here

Pretty simple really, just takes WILL

NoJusticeNoPeace

(5,018 posts)
2. ACA does NOT allow UNDER-INSURANCE unless they are referring to deductibles and copays
Mon Dec 1, 2014, 06:34 PM
Dec 2014

If this study refers to inability to pay deductibles and copays then that makes sense, all the more reason to go to

SINGLE PAYER

But someone having insurance with deductibles is FAR better than having no deductible because you have

no insurance

SoCalDem

(103,856 posts)
4. There are millions who have gotten insurance, BUT
Mon Dec 1, 2014, 07:53 PM
Dec 2014

when you live hand-to-mouth...paycheck-to-paycheck, ANY "extra" expense can be devastating..

It's nice to think that people will just go to the doctor, but if you have a $20 co pay and are charged a fee for labs (every doctor wants labs)..and then another copay for meds.. You are out a fast $100 easy..

Poor folks just do not have an extra $100 laying around, waiting to be spent.

zipplewrath

(16,648 posts)
17. If it is?
Mon Dec 1, 2014, 10:15 PM
Dec 2014

If it is an improvement, why are there MORE people putting off medical care even though they are insured?

 

yeoman6987

(14,449 posts)
7. Single payer would cost even more for people
Mon Dec 1, 2014, 08:17 PM
Dec 2014

I know seniors who have to have a supplement to Medicare to corner the 20 percent and other costs. They are paying another 250 a month. So a total of close to 500 dollars for medical a month. Can working families pay that today? Most are paying way less with ACA.

 

yeoman6987

(14,449 posts)
9. Canada also pays 60 percent in taxes...everyone
Mon Dec 1, 2014, 08:29 PM
Dec 2014

40 percent to pay bills and live will not leave us with much left if we even have enough for basics.

NoJusticeNoPeace

(5,018 posts)
10. People in Canada do just fine for the most part, and I am not sure about your stats
Mon Dec 1, 2014, 08:31 PM
Dec 2014

But all we have to do here is tax the rich and corps and make it impossible for them to sell something here that isnt made here.

But we as a society dont have the will to do that

Paula Sims

(898 posts)
13. I would rather pay more in taxes than the $25k our of pocket non-covered items
Mon Dec 1, 2014, 09:00 PM
Dec 2014

Even though I have an amazing policy under my employer, I still have to pay a huge chunk out of pocket for "experimental" tests such as determining if I have muscular dystrophy or hypokalemic partial paralysis (16k out of pocket). Both considered "experimental" although treatment would improve quality of life or life determining factors. Nope -- protesting doesn't help.

We need single payer, yes, but we also need cost controls by hospitals, labs, and other medical providers. Canada does well because they pay the higher taxes and their medical professionals accept that they're doing a service -- not getting to be God for a day.

TheKentuckian

(25,333 posts)
11. Medicare isn't single payer, "Medicare for all" is mostly marketing to give folks a familiar
Mon Dec 1, 2014, 08:31 PM
Dec 2014

and popular anchor point but the reality is it is just standard 80/20 with no maximum out of pocket and a boondoggle of a prescription plan added under Bush.

alarimer

(16,350 posts)
16. I've had insurance for years and don't go to the doctor because of co-pays.
Mon Dec 1, 2014, 09:49 PM
Dec 2014

Can't afford it. $70 here, $30 there. Plus 20% of some things that might run into the hundreds.

Health insurance is not health care.

Medicare, with all its gaps, is still not good enough. We need a system like Britain's NHS or a single payer Canadian-style system where EVERYTHING is covered. You don't pay 20% of this, $30 of that.

eridani

(51,907 posts)
18. 70% of those who file for bankruptcy due to medical reasons have insurance
Mon Dec 1, 2014, 10:23 PM
Dec 2014

That is underinsurance by any definition, and ACA has not changed that.

NoJusticeNoPeace

(5,018 posts)
12. Not worthless, what would you rather have over your head
Mon Dec 1, 2014, 08:32 PM
Dec 2014

a $5000 bill for deductible you cant pay or a $500,000 bill for services rendered you cant pay?

and dont say you cant pay either because that isnt true.

might take you a few years to pay the $5000 but you will never pay the other

KT2000

(20,690 posts)
14. who gives a few years
Mon Dec 1, 2014, 09:09 PM
Dec 2014

to pay $5,000? A person who does not pay does not get the care. If you do run up the bill, our hospital (the only one and it also owns most of the clinics too) does whatever it takes to get their money.

The actual circumstances people live with are varied. If one has no credit cards, savings account, and a fixed social security income, there are no other resources/assistance if the SS is over $999. After rent, not much left for things such as supplemental insurance and the clinics want their money upfront.

There are not always choices.

LiberalElite

(14,691 posts)
22. It seems to me that
Tue Dec 2, 2014, 12:03 AM
Dec 2014

if you can't pay the $5,000 deductible you will never get to the point of receiving services necessitating a half a million bill.

Le Taz Hot

(22,271 posts)
15. Thank you for this.
Mon Dec 1, 2014, 09:10 PM
Dec 2014

It's a subject almost impossible to talk about on DU. This is key:

"While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost."

The cheerleaders want to talk about how many more people are insured, but insurance isn't health care. These plans with $6,000 per person per year deductible are virtually worthless. Even if you have a major illness/accident, that $6,000 a year with a $12,000 a year cap just means the difference between the amounts you'll get to write off in a bankruptcy. The end result is the same -- financial ruin.

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