More and More Americans Are Uninsured

By Linda Orlando

A report by the Commonwealth Fund, a private health-care policy foundation based in New York, says that there has been a dramatic increase since 2001 in the number of middle-class Americans without health insurance. The study of 4,350 adults with moderate to middle incomes revealed that the percentage who lacked health insurance for at least part of the year rose to 41% last year. That percentage was only 28% in 2001. About 45.8 million Americans did not have health insurance coverage in 2004, according to the U.S. Census Bureau. The percentage of people in all income brackets without health insurance rose to 28% last year, up 4% from 2001

The report also says that people without insurance are more likely to skip recommended health screenings such as mammograms and colonoscopies, and they are less likely to have a regular doctor. More than half of the uninsured adults surveyed said that they are having problems paying medical bills or had gone into debt to cover medical expenses. Researchers found that the cost of medical treatment prevented 41.1% of uninsured adults from seeing a doctor, compared to 9.2% of adults with health care coverage. 51% of women without health insurance have not had a mammogram in two years, compared with 22.8% of women who have insurance. And over 76% of uninsured men between 30 and 64 have not had a PSA test to screen for prostate cancer in two years.

The study also found that 59% of uninsured people with chronic conditions such as diabetes or asthma either went without their medicine or skipped doses now and then because it was too expensive. At least 30% of the people with chronic conditions had either gone to the emergency room, stayed overnight in the hospital, or both, compared to 15% of uninsured people with chronic ailments. Sara Collins, a senior program officer at the Commonwealth Fund, said that those statistics indicate that giving up medicines can lead to more expensive health problems later. And treating patients in costly settings such as hospital emergency rooms puts a huge financial burden on the nation’s healthcare system.

The study also points out that many employers are dropping health care coverage as an employment benefit, or offering plans that are too expensive for many people to afford. Collins said that the report spotlights the health care crisis many uninsured middle-class Americans are facing. "It represents an explosion of the insurance crisis into those with moderate incomes," she said. "People not being able to take care of themselves should send out a big red flag."