1 in 4 adults had insurance but still couldn’t afford medical care

[n2doc]

More than 1 in 4 adults who bought insurance for themselves or their families last year had to skip needed medical care because they couldn't afford it, according to a study released Thursday by Families USA, a consumer health group.

Some signed up for coverage on the new health insurance exchanges under the Affordable Care Act and received financial assistance to help pay their premiums and some of their out-of-pocket costs. Others bought their plans directly from insurance companies.

But even with the gains under the health-care law, 25.2 percent of adults who bought insurance on their own last year said they went without medical tests or treatments, prescription drugs or doctor visits because of cost. Because most adults who buy insurance on their own do not have dental care as part of their health coverage, the ability to see a dentist was not included in the main part of the report.

But when dental care is added to the mix, it becomes the most common type of care that adults skip because of its cost.
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http://www.washingtonpost.com/news/to-your-health/wp/2015/05/14/1-in-4-adults-had-insurance-but-still-couldnt-afford-medical-care/?postshare=5541431691772625

[antigop]

1. as I repeatedly have stated...it doesn't do you any good to have insurance you can't afford to use.

nt

[Dragonfli]

8. In a tiered health care system such flaws are features

It is a system where different people are valued differently and it is regressive.

Those with more comfortable financial means are gold valued people and the design allows them to receive care by providing the cheapest copays they can easily afford

Those with the least financial means (*and therefore the least ability to pay copays) are bronze valued people and the design allows them via subsidy to buy mandatory insurance they really can't afford while providing them the highest possible copays to insure they will seldom be able to actually access health care itself.

The bronze valued people, because they pay premiums, help bring down the costs so that the gold valued people can save money while receiving the health care that is financially unavailable to the bronze valued people.

This makes the gold valued people happy, and the bronze valued people, well, they aren't worth very much so who cares anyway? It's not like bronze is worth anything.


A progressive system would work in the reverse, those with the least would pay the least to receive care and those with the most would pay a bit more to receive care. This tired system designed to ration care to the underclass and reduce costs to the upper class is made possible by conflating insurance with health care and is driven by a cynicism that would place different values on people as if they were nothing more than usable resources.

There should only be one tier of health care and the highest and lowest among us should have exactly the same access to it.

But such cynicism that would go so far as to value people differently based on their income would of course simply use the lower classes as premium fodder in order to reduce costs for those valued more highly, this is the true nature of a uniquely American system of healthcare.

Insurance is not healthcare, but rather a means to ration health care and insurance companies only serve one function and it is not to provide health care, they don't even dispense aspirin, they are only there as gatekeepers to provide a care denial system, they serve no other function but to restrict access to actual health care (well, except to profit from restricting access, but that is another story)

[daleanime]

20. +1

[historylovr]

21. +1

[Jackpine Radical]

23. Very much on-target.

The facts have been pointed out before but your tying the system to the valuation of people is stark, gut-wrenching, and ought to be spread as far as you can get it to go.

[Dragonfli]

33. I pointed out this obvious problem with a tiered system based on income

Early on, and noted the irony of classifying us as metals of varying value, I was making this same argument during the debates and after.

All I got was huge pile-ons about what an asshole I was for criticizing such a brilliant and progressive plan and suggestions that I was pointing out these design flaws due to racism or hidden Republicanism. It got so bad I stopped posting for several months.

It was nonetheless as true then as it is now.

I was shocked frankly that any Democrat would go with a tiered system, the tiers mean unequal care no matter how the tiers are decided. I just assumed a Democrat would push something where everyone was treated equally in a single tier system, instead to my amazement all they wanted to do was argue the degree to which those that were bronze people would have to be soaked at point of use to dissuade enough from seeking treatment and keeping costs down.

I recognized the plan and it's flaws back when I first heard of the scheme in the early nineties when Bob Dole and Newt Gingrich were pushing it, so it was not new to me.

What was new was that a regressive scheme such as this, designed to profit middle men more than anything was now reclassified as somehow progressive and Democratic.

The definitions appear to have changed but the con remained the same.

[Yo_Mama]

42. Yes, but this is morally appalling

To set up a government-mandated system that essentially extracts resources from the less affluent and diverts them to the better-off is beyond sick. "Depraved" is the word I want to use.

[Dragonfli]

43. I don't disagree /nt

[CoffeeCat]

45. And this is exactly how the insurance companies want it...

What a scam they've got going. We pay premiums, basically for nothing! The copays and deductibles are so high, everyone is prices out of going to the doctor.

But you HAVE to carry insurance. Because what if something catastrophic happens to you--like a car accident or you get really sick? The insurance companies really win big here. Because even though you have insurance and the majority of costs are covered, you are still going to owe tens of thousands--maybe hundreds of thousands of dollars--if you develop a serious, long-term illness or are in an accident or you have to have surgery.

Seriously. Our system is rigged. It is criminal.

[CoffeeCat]

46. self delete--duplicate (nt)

[antigop]

2. Most Americans can't afford a $1,000 emergency expense

http://money.cnn.com/2011/08/10/pf/emergency_fund/index.htm
When the unexpected strikes, most Americans aren't prepared to pay for it.

A majority, or 64%, of Americans don't have enough cash on hand to handle a $1,000 emergency expense, according to a survey by the National Foundation for Credit Counseling, or NFCC, released on Wednesday.

Only 36% said they would tap their rainy day funds for an emergency. The rest of the 2,700 people polled said that they would have to go to other extremes to cover an unexpected expense, such as borrowing money or taking out a cash advance on a credit card.

"It's alarming," said Gail Cunningham, a spokeswoman for the Washington, DC-based non-profit. "For consumers who live paycheck to paycheck -- having spent tomorrow's money -- an unplanned expense can truly put them in financial distress," she noted.

[antigop]

3. Unable to meet the deductible or the doctor

http://www.nytimes.com/2014/10/18/us/unable-to-meet-the-deductible-or-the-doctor.html

Patricia Wanderlich got insurance through the Affordable Care Act this year, and with good reason: She suffered a brain hemorrhage in 2011, spending weeks in a hospital intensive care unit, and has a second, smaller aneurysm that needs monitoring.

But her new plan has a $6,000 annual deductible, meaning that Ms. Wanderlich, who works part time at a landscaping company outside Chicago, has to pay for most of her medical services up to that amount. She is skipping this year’s brain scan and hoping for the best.

“To spend thousands of dollars just making sure it hasn’t grown?” said Ms. Wanderlich, 61. “I don’t have that money.”

About 7.3 million Americans are enrolled in private coverage through the Affordable Care Act marketplaces, and more than 80 percent qualified for federal subsidies to help with the cost of their monthly premiums. But many are still on the hook for deductibles that can top $5,000 for individuals and $10,000 for families — the trade-off, insurers say, for keeping premiums for the marketplace plans relatively low. The result is that some people — no firm data exists on how many — say they hesitate to use their new insurance because of the high out-of-pocket costs.

[Autumn]

4. Health insurance finance reform is not Health Care reform

Recommended

[zipplewrath]

17. AIA

It was in correctly named. It is the Affordable Insurance Act.
Or as some of us were calling it back the:

The Health Insurance Industry Stimulus Package.

[In_The_Wind]

5. I can't afford to buy my insulin when I hit the gap in prescription coverage two months from now.

[Dont call me Shirley]

14. I'm so sorry, In_The_Wind

I almost died from no health insurance and no $ to pay privately. It's time to end this insanity.

Healthcare is a Right, not a GD F**** G privilege!

[In_The_Wind]

18. The sad fact is: I pay for Medicare and extra medical insurance.

We don't go out. No movies, no dinners, nothing beyond what is essential.

[Dont call me Shirley]

19. Same here.

It's time to make the rich pay for the diseases they are causing us to suffer from!

To profit from someone's disease is a double tragedy.

[antigop]

15. so sorry, In_The_Wind. So very sorry. nt

[brewens]

6. We're nowhere close to being done yet. It has to shake out somehow that people get the medical care

they need for what they can afford to pay. I work for a blood center. It's kind of an average Joe type job but is in the medical field. I know I'd like to keep working. Others working for providors better get a clue if they hope to do the same. Looking out for the insurance companies was not the way to go. Leading up to the ACA being passed, I kept hoping to see medical insurance companies stock tank big time! That would have told me we were on the right track.

[colsohlibgal]

7. Just Plain Evil

To make huge profits off health care is an abomination. The germ of all this is in Nixon's "White House Transcripts". One of his big aides told him of this new thing called an HMO, to shift much more of the cost to patients. Nixon said that sounded great, in his unique style.

And here we are, huge profits to health care companies sucking money out of the dead, dying, sick, and their families.

[antigop]

9. here is the video

[CountAllVotes]

10. Have insurance

Problem is, I cannot find a doctor that wants the likes of me as a patient (disabled with chronic pain). Life is so much fun these days NOT.

This whole thing has done me no good at all except costs have tripled on medications.

[antigop]

11. wow, Count, so sorry...I dream of the day when we live in a civilized society. nt

[CountAllVotes]

13. yeah it truly sucks

I'm still looking for a new doctor as I finally faced the fact that the one I've been going to is abusing me and abusing me horribly. Was told by Medicare, my supplemental ins. carrier and the Medicare D carrier (Caremark) to turn said doctor in to the AMA, etc. after I told them what is going on.

They've all told me to find a new doctor but no luck so far.

1st question: Are you using any controlled substances?
2nd question: Are you disabled?

After I answer these questions I usually get hung-up on.

Makes you feel like a piece of total crap, believe me.

I don't know what I will do if I run out of medications and find no doctor to refill them. This War on Drugs is doing me no good at all.

[Hangingon]

36. We went 5 months without a doctor.

Ours closed his traditional practice and opened a concierge practice - no Medicare and no insurance taken. We "applied" to 6 practices that were supposedly taking me patients. Still waiting. Just like job hunting. We have full insurance with our retirement. Good credit record. No alcohol or drug issues just normal medical issues for 70 year olds. Prescriptions are running out so we wrote a BIG check to go back to our old doctor. AFA has not worked well for us.

[Dont call me Shirley]

12. Medicare E (E = Everyone)

[daredtowork]

16. Health insurance costs have ballooned for employers and city governments

Also, psychologically, I think the Bronze people need to be receiving a non-copay service or else it will feel like they keep paying for nothing (unless they DO suddenly have an emergency that's covered). This feeling of paying for nothing will build up as hostility toward the system.

[daleanime]

22. Because we continue to try profit off of those who did health care.....

[Orrex]

24. I'm amazed that it's only 1 in 4.

I'd have guessed 1 in 3 or 3 in 5 at a minimum.

[Yo_Mama]

40. For lower/middle income it is about 1 in 3 - 32%

Hardest hit were lower to middle-income adults. That's someone who earned from $16,200 to $29,199 last year, or a family of three earning from $27,400 to $49,499. Almost one out of three of these adults said they went without needed medical care because the out-of-pocket cost was too high.

And ACA really hasn't helped many of these people:

The estimated average deductible of silver plans in 2014 was between $2,267 and $3,030, the report said.

I don't know quite what I think, but we haven't solved our problems - instead they seem to be getting worse.

At the clinic a lot of people refuse to go for recommended tests because they don't have the money. It used to be that you asked if they had insurance. Now you ask about what it's going to cost them, and document refusal of care in the records because "insurance gap". It's all just a game of russian roulette played with an insurance card. We now have more refusals of care for those insured than for those not insured. We have plenty of people refusing to go to the ER with insurance now.

We have created a system in which people have to pay in, but some are essentially debarred from getting treatment. It's a winner-takes-all type of system, and in the future we will be paying higher medical costs because of it.

And when people know they can't afford to use it, they refuse even the screening tests, because their theory is that there is no point to them.

[jtuck004]

25. How many of those had decent food which might have prevented the need for "health care"?

Bet a few of them had to skip whole days.

Build on crappy foundations you just make a mess.

[fasttense]

27. Well put 1000. n/t

[CountAllVotes]

29. +1,000 !!!

What a tremendous disappointment this tool of a politician has proven to be.

Far more harm than any good at all in many cases as we are now seeing!!!

[SMC22307]

38. "Alas, we needed a leader ... and got just another politician."

Precisely. And all the more so after 8 years of Dubya and Darth Cheney.

I have to laugh at those who believe Obama is Mt. Rushmore-worthy. He's got some fucking nerve lashing out at Elizabeth Warren for being "just another politician."

[woo me with science]

57. [phone]

[PumpkinAle]

28. I have insurance - it is far from inexpensive

and I haven't used it because of all the co-pays, prescription costs, etc., very high and not very good. It is ridiculous.

So absolutely do I think 1 in 4 can't and couldn't afford medical care.

[Half-Century Man]

30. That's me

COPD meds are beyond my means.

[brer cat]

47. Have you checked any Canadian pharmacies?

I used to pay 100% out of pocket for my asthma meds and I found it much cheaper from Canada. I take advair which runs around $250 a month here and $50 from Canada. That comparison is brand name, not generic.

[redstatebluegirl]

31. I can believe this.

It has become common place for healthcare providers especially hospitals and emergency clinics to ask for money up front to cover what they "believe" the insurance will not pay. Sometimes this can be 1000's of dollars, especially where surgery is involved.

Our healthcare costs are out of line. Our hospitals look like five star hotels. I don't need a five star hotel, I need a clean, sanitary facility. The place that did my cataract surgery had expensive thick carpet in the waiting room, expensive art on the walls and cushy chairs. Of course this place tried to sell me 5600 dollar lenses instead of the ones the insurance paid for.

Doctors and nurses deserve a decent salary for what they do, but some of the other perks we see in waiting rooms and hospitals are fluff. Of course there is the 40 dollars I was charged for an ibuprophen when i was hospitalized recently.

Just because you have insurance doesn't mean you can afford healthcare.

[Spacemom]

32. I have to have surgery next week

I have to meet my deductible first ("thankfully" only $2500) first. Then insurance will only cover 80%. It's all having to go on the credit card. So I'll go in to debt and pay even more in interest. And I counted myself lucky I had the credit card to put it on.

The system is broken.

[SMC22307]

39. Good luck, and a speedy recovery to you.

Yes, the system is most definitely broken.

[Liberal_in_LA]

34. kick.

[MadrasT]

35. K&R

Because this pisses me the fuck off like nothing else. My husband died from diabetes from lack of real affordable care.

[Yo_Mama]

37. When you look at the details it gets worse

From the article:

Hardest hit were lower to middle-income adults. That's someone who earned from $16,200 to $29,199 last year, or a family of three earning from $27,400 to $49,499. Almost one out of three of these adults said they went without needed medical care because the out-of-pocket cost was too high.

[pnwmom]

41. Medicaid and all other plans should cover needed dental care (excluding primarily cosmetic).

Dental care is just as necessary for health.

[progressoid]

44. Yep. We're still paying off 2013 and 2014 bills.

AND still paying for insurance. My wife needs to see someone again, but we can't afford it.

[Scuba]

48. Of those who file for bankruptcy for medical bills, most had insurance ....

http://www.nbcnews.com/id/6895896/#.VVcdH7lVikp

Most of those seeking court protection from creditors had health insurance, with more than three-quarters reporting they had coverage at the start of the illness that triggered bankruptcy.

[marym625]

49. Single payer

The ACA has done good things. But the difference from before hasn't changed the outrageous profits the insurance companies make, which in turn, hurts health care. It also has actually hurt many, as the OP points out.

Personally, to keep my doctors, my plan went up $200 a month. I can't afford it. But I can't afford to lose my doctors more

The give in to the big pharm and insurance companies was bullshit. The dems had control when President Obama first took office. The excuse that he couldn't get it passed seemed shady at the time. Now, it's evident he was working for the corpocracy.

[1StrongBlackMan]

50. Am I the only one who ...

has a problem with an on-line article about a report making a bold statement, positive or negative, that does not like to the original report?

[djean111]

51. What will be interesting is when the MIC and Big Pharma and Private Health Insurance all start

scrabbling for our money. Goodness, won't be enough left over for us to buy "stuff". Factor in student loans, and lower-paying jobs and fewer hours, and ta-da! Won't be much left over except scraps for food and discretionary spending and transportation.

[KittyWampus]

52. adults who bought insurance on their own-

ie, without using Obamacare.

[TexasBushwhacker]

53. Until there is full transparency of healthcare costs

we will continue to pay through the nose, and other body parts.

A single Vicodin in the hospital shouldn't cost $20.

[historylovr]

54. Kick

[madville]

55. I had $6,000 out of pocket last year

And my premiums are $9600 a year so last years medical expenses were a total of $15,600. Of course all the bills were about $40,000 so it did cover a large part of it.

[sammythecat]

56. Plenty of "other countries", i.e. more advanced societies,

have paved the way and shown clearly that it doesn't have to be like this. The only reason it is this way in this country is because of the callous and relentless greed of the few and the exasperatingly apathetic ignorance of the many. What does it take for people to wake the f up start looking out for their own best interests?

[randys1]

58. ACA still HUGE improvement over no ACA , but if you want real change,then you have to hit

the streets and DEMAND it.

Are we willing to do that?

By the TENS of millions?

[fadedrose]

59. Medicare presents the same problem

The deductibles are too high, and I feel the money could go to something else if I just suffer a bit more.

I do like to spend my little SS on my kids, grandkids, dog and birds and feel like I'm robbing them (and myself the pleasure of giving) ...so I take a pain pill, buy some bird seed, and wait for the grim reaper.

It seems wasteful to spend money on a body that has so little time left on the earth. Not a good investment since I don't think I will find a cure for cancer in the next year or so. No loss....