The lack of health insurance is preventing more than 11 million Americans from receiving care for chronic illnesses, according to results of a study released yesterday.
An article published in the August 5 issue of the Annals of Internal Medicine showed that working-age adults with one or more chronic illnesses who reported they were uninsured were four times more likely than those with insurance to have not seen a health professional in the past year.
Those without health insurance also were six times more likely to identify a hospital emergency department as the standard site for receiving treatment for illness.
“Many Americans are locked out of the system because they are uninsured and cannot afford…life-saving care,” said Andrew Wilper, MD, lead author of the study.
“Many of these individuals end up with preventable emergency room visits, hospitalizations, amputations, kidney failure or worse because their chronic condition has gotten out of control,” said Wilper, who currently teaches at the University of Washington School of Medicine in Seattle.
Researchers from Cambridge Health Alliance and Harvard Medical School analyzed data from surveys conducted by the National Center for Health Statistics and found that there are 11.4 million non-elderly adults with one or more chronic conditions who lack health insurance.
Nationally, experts estimate that some 47 million American lacked health insurance in 2006.
Uninsured people with chronic illnesses face serious obstacles in getting the care they need, but Wilper believes that people enrolled in high-deductible health plans often face similar barriers to getting regular medical attention.
Wilper said some of these HDHP members could be classified as underinsured.
“Some plans, for example require people to pay medical bills of $5,000 out-of-pocket before their insurance kicks in,” he said. “These plans put people in the precarious state of being underinsured, which is not much better than lacking health insurance all together.”
Care delivered in emergency departments is typically too expensive and comes when illnesses have reached serious stages, said Steffie Woolhandler, MD, a co-author of the study.
“Emergency rooms may provide too little, too late for the millions of uninsured with chronic conditions. They need regular medical monitoring, and a steady supply of medications to control their illnesses, and a whole array of services that are out of reach for the uninsured.,” she said. “Only national health insurance can fix this broken system and save thousands of lives each year.”