The ranks of Americans without health insurance continued to
swell last year, with Census figures showing 45 million Americans
were without coverage in 2003 -- an increase of 1.4 million from
the previous year. Apart from the inability to cope financially
with the skyrocketing costs of catastrophic accidents or illnesses,
the uninsured are more prone to neglect regular medical assessments
and appropriate preventative care. In turn, this perpetuates a
vicious cycle of higher incidents of serious medical issues that
ultimately drive healthcare costs higher.
Gallup's 2004 Health poll* further illustrates the seriousness
of the problem. Eleven percent of U.S. adults say they do not have
any health insurance through Medicare, Medicaid, or private
insurers. Slightly more than a quarter (26%) of American adults say
that -- within the past year alone -- they have put off seeking
medical treatment for themselves or a family member because of the
out-of-pocket costs it would incur.
Naturally, those whose incomes don't necessarily force a choice
between paying insurance premiums and putting food on the table are
more likely to have insurance. People with higher annual incomes
are dramatically more likely than are those with lower incomes to
have health coverage. Only 3% of Americans with annual household
incomes of $75,000 or more say they are not covered, while that
number rises to 21% among those earning less than $30,000
annually.
Data compiled by CoverTheUninsured.org, a project of the Robert
Wood Johnson Foundation, shows that one-fourth of uninsured
Americans live below the federal poverty line. CoverTheUninsured
also reports that the likelihood of being uninsured as an adult
gradually decreases as age increases, partly because young adults
are less likely to have jobs offering health insurance, and because
most elderly Americans are covered by Medicare. Foreign-born
Americans are nearly three times as likely as U.S.-born Americans
to be uninsured. Americans employed in blue-collar jobs, such as
agriculture, construction, and transportation, are also
disproportionately likely to go without insurance.
Putting Off Healthcare
It may be troubling that 26% of Americans say that medical costs
kept them from seeking care, but even more alarmingly, 6 in 10 of
those who put off treatment say that the condition or illness for
which they did not seek care was either "somewhat serious" (44%) or
"very serious" (16%). Such delays in care lead not only to higher
costs of treatment (when conditions are not caught until they are
in more advanced stages), but in the case of serious diseases such
as cancer and heart disease, can often mean the difference between
life and death.
Gallup's numbers confirm there is a strong link between lack of
health insurance and the need to put off medical care, with 54% of
those who have no coverage saying that they delayed seeking care in
the last year. But although those without health insurance are most
likely to avoid seeking medical help, this problem is not
restricted to people completely lacking in coverage. More than 2 in
10 (23%) of those with private health insurance say they put off
medical care within the last year because of the cost.
Bottom Line
Out-of-pocket costs for medical care and prescription drugs have
increased over recent years, and U.S. workers are more likely now
than they were three years ago to be asked by their employers to
shoulder part of their healthcare costs. Sixty-four percent of
adults with private insurance now share the cost of their
healthcare, compared with 54% in 2001. When asked about changes in
the amount they have to pay for health insurance within the past
year, 76% of those who pay all or part of their medical insurance
report that the amount has gone up, with 28% saying it has gone up
"a lot."
*These results are based on telephone interviews with 1,016
national adults, aged 18 and older, conducted Nov. 7-10, 2004. For
results based on the total sample of national adults, one can say
with 95% confidence that the margin of sampling error is ±3
percentage points. In addition to sampling error, question
wording and practical difficulties in conducting surveys can
introduce error or bias into the findings of public opinion
polls.
For results based on the sample of 709 adults who are not
insured by Medicare or Medicaid, the maximum margin of sampling
error is ±4 percentage points.
For results based on the sample of 619 adults who have
private health insurance, the maximum margin of sampling error is
±4 percentage points.
For results based on the sample of 509 adults who pay all or
part of their health insurance premiums, the maximum margin of
sampling error is ±5 percentage points.
For results based on the sample of 245 adults who have put
off medical treatment due to cost within the past 12 months, the
maximum margin of sampling error is ±7 percentage
points.
