Hospital Business Week (pg. 144)  [Printer-friendly version]
August 26, 2007

INSURED BUT NOT ADEQUATELY COVERED

Consumer Reports Health Insurance Survey Reveals 1 in 4 People Insured
but Not Adequately Covered

A new Consumer Reports study identifies the "underinsured" --
accounting for 24% of the U.S. population -- living with skeletal
health insurance that barely covers their medical needs and leaves
them unprepared to pay for major medical expenses.

Forty-nine percent of people overall, and 43 percent of people with
insurance said they were "somewhat" to "completely" unprepared to cope
with a costly medical emergency over the coming year. Some 16 percent
of the people surveyed had no health plan at all, including many
working respondents whose jobs didn't offer insurance or who couldn't
afford the premiums of deductibles of the available plan.

When added to the population of "uninsured" -- approximately 16% of
the population -- a total of 40% of Americans ages 18-64 have, at
best, inadequate access to health care. The report, published in the
September issue, also finds that most employers are struggling to keep
up while the insurance behemoths prosper from the misery.

In the first of a series of reports on America's health care crisis,
Consumer Reports paints a profile of the "underinsured," explains what
it means to be insured but not adequately covered, and tells of the
costs and consequences for everyone, including people who are
currently "well insured." The report is based on a survey conducted by
the Consumer Reports National Research Center in May 2007, which
sampled 2,905 Americans between ages 18 and 64. The survey found
evidence of increasing frailty in the U.S. system of health insurance
on almost all fronts.

The September issue of Consumer Reports also includes ratings of the
best HMOs and PPOs, based on the experiences of 37,000 readers.

Defining "Underinsured": Insured But Not Covered

People falling into the "underinsured" category have two or more of
the following complaints about their health plans: It does not
adequately cover costs of prescription drugs; doctor visits; medical
tests; surgery or other medical procedures; catastrophic medical
conditions; or the deductible is too high.

CR notes that the new emerging class of "underinsured" could be you or
your neighbor. In the CR survey, the median household income of
respondents who were "underinsured" was $58,950, well above the U.S.
median. Twenty-two percent live in households making more than
$100,000. Still, many of the "underinsured" don't have the resources
to keep up with the rising costs of deductibles and co-pays, so much
so that 43% reported that they postponed going to the doctor because
they couldn't afford it.

Twenty-eight percent told Consumer Reports they put off filling
prescriptions. In addition to digging deep into their savings, raiding
their retirement accounts and running up credit card balances, 27% of
the "underinsured" said they were still in debt to doctors and
hospitals. Three percent said medical bills had forced them to declare
bankruptcy.

This article was prepared by Hospital Business Week editors from staff
and other reports.

Copyright 2007, Hospital Business Week