By Aliza Marcus
Aug. 20 (Bloomberg) -- Medical bills were cited as a burden by 41 percent of working-age Americans in a survey, up from 34 percent two years earlier.
An estimated 72 million adults under age 65 have difficulty paying their medical bills or are paying off debt from health- care expenses, based on the survey, taken last year and released today by the Commonwealth Fund, a health-policy center in New York. Sixty-one percent of those struggling said they had health insurance.
Health-care costs have been rising at about double the rate of inflation and faster than wages. That's making it increasingly difficult for those without insurance to pay their bills and for those with coverage to afford co-payments, deductibles and gaps in coverage, said Commonwealth Fund officials on a conference call yesterday with reporters.
"The survey showed that our health system is falling short of where it should be," said Karen Davis, Commonwealth's president, during the call. "This highlights the need for the new administration to make health-care reform a priority."
The survey of 3,501 adults was conducted from June 6 through October 24, 2007, and the results were compared with a similar study two years earlier.
Based on the newer survey, 28 million Americans used all their savings on medical expenses, 21 million built up substantial credit-card debt and 21 million couldn't pay for basics such as food, heat or rent.
"Working people are struggling to pay their bills and accruing medical debt," said Sara Collins, the fund's assistant vice president, in a statement.
The medical patchwork in the U.S. of private insurance backed up by limited government care leaves people vulnerable, Davis said.
Costs Internationally
In a 2005 international survey by the Commonwealth Fund, half of Americans said they had problems getting needed medical care because of cost, compared with a low of 13 percent in the U.K. and a high of 38 percent in New Zealand.
In the survey released today, adults at all income levels spent more of their income on out-of-pocket costs and premiums in 2007 than they did six years earlier, according to the biennial survey.
Twenty-five percent of people earning $60,000 or more reported difficulties with medical costs, compared with 20 percent in 2005. Fifty-three percent of people with incomes of less than $20,000 said they had problems, up from 43 percent.
As published on:
http://www.producersweb.com/r/WIRE/d/contentFocus/
?adcID=9eee6c77cf901e69731a0bf826215bb9
Linda Young - AHN Editor
10:32 a.m. EST Washington, D.C. (AHN) - It isn't just the 47 million Americans that lack health insurance who aren't able to afford to see a doctor anymore, a new survey finds that nearly a quarter of Americans have reduced the number of times they see their doctor to save money.
National Association of Insurance Commissioners researchers found that 22 percent of respondents were cutting back on visiting the doctor to cut costs, often putting their health at risk as a result.
The Insurance Commissioner's survey was done in July by surveying 686 consumers.
Approximately 11 percent of respondents also said they had cut back either the number of prescription medications they were taking, or cut the dosages to make the prescription last longer to save money.
This survey follows two recent studies that also revealed the increasing problems Americans are facing in trying to take care of their health in tough economic times. One study was on uninsured Americans, while the second was on those with insurance.
A study published in this month's issue of the Annals of Internal Medicine found that one out of three people of working age are uninsured and suffering from a chronic Illness, for which they aren't getting the medical care that is required.
An earlier study, with a larger sample than the Insurance Commissioners survey, had found that 25 percent of Americans with insurance couldn't afford to use it.
KANSAS CITY, Mo., Aug. 12 /PRNewswire/ -- To save money, many Americans are cutting back on medical care -- potentially putting their health at risk -- according to new research from the National Association of Insurance Commissioners (NAIC).
A national survey of 686 consumers, fielded in July, found that 22 percent of U.S. consumers say they have reduced the number of times they see the doctor as a result of today's economy. Furthermore, 11 percent of consumers say they have cut back the number of prescription drugs they take or the dosage of those medications to make the prescription last longer.
"Delaying medical treatment and regular physicals puts consumers at risk for potential health issues -- and increases overall health insurance costs," said NAIC President and Kansas Insurance Commissioner Sandy Praeger. "It's critical that consumers continue to take responsibility for their health, so that we can all benefit from healthier lives and more affordable healthcare."
And, while consumers might be making budget cuts in other areas, the NAIC's survey revealed that the vast majority have not reduced, cancelled or otherwise made changes to their insurance policies.
"Insurance is an important -- and oftentimes mandated -- purchase for most Americans," Praeger said. "That is why the NAIC and state insurance regulators are committed to helping every American be a smarter insurance consumer."
Following is a summary of the key research findings: Auto Insurance -- 80 percent of consumers have not made changes to their auto insurance policy. -- However, 7 percent of consumers reported changes. Of those, 4 percent reduced coverage, 2 percent fell behind on payments and 1 percent cancelled their policy. Homeowners Insurance -- 74 percent of consumers have not made changes to their homeowners insurance policy. -- However, 5 percent of consumers reported changes. Of those, 2 percent reduced coverage, less than 1 percent fell behind on payments and 3 percent cancelled their policy. Health Insurance -- 85 percent of consumers have not made changes to their health insurance policy. -- However, 5 percent of consumers reported changes. Of those, 2 percent reduced coverage, 1 percent fell behind on payments and 2 percent cancelled their policy. Life Insurance -- 78 percent of consumers have not made changes to their life insurance policy. -- However, 6 percent of consumers reported changes. Of those, 1 percent reduced coverage, 2 percent fell behind on payments and 3 percent cancelled their policy.
The NAIC offers tips for consumers on how to lower their insurance premiums through its public education program, Insure U, at www.InsureUonline.org. The program is also available in Spanish at www.insureuonline.org/espanol.
Tips to Help Consumers Lower their Auto Insurance Premiums
-- Consider safety devices if you're buying or leasing a new car. For example, getting a car with anti-lock brakes, side air bags, automatic seat belts and daytime running lights can help you save on premiums.
-- Install anti-theft devices on your car, such as an alarm system or global positioning system so that your car can be located if stolen. Notify your insurance provider if you have these devices or have recently installed them.
-- Maintain a good driving record, as the number of accidents, DWI/DUI citations, claims and tickets directly affect your premiums.
-- Call your insurance provider and ask about eligible discounts such as a multi-car discount, good grades (for students under 25 years of age) and mature driver (for consumers between 50 and 65 years of age) among others.
Tips to Help Consumers Lower their Homeowners Insurance Premiums
-- Install protective devices -- such as a burglar alarm system, smoke detectors and deadbolt locks. Notify your insurance provider if you have these devices or have recently installed them.
-- Consider consolidating your homeowners and auto insurance policies with the same insurer, as you might be eligible for a multiple-policy discount.
-- Maintain a good credit history. Many insurance companies consider credit history when determining how much to charge for insurance.
-- If you can afford to pay for minor repairs out of pocket, you might want to consider raising your deductible.
Tips to Help Consumers Lower their Health Insurance Premiums
-- If you're married and both spouses work at jobs that provide health insurance, compare these policies and their costs to see which one best fits your needs. Look beyond the monthly amount you must pay and closely evaluate covered services, co-pay requirements, deductibles and reimbursement levels so that you make the best choice for your family and your pocketbook.
-- Stay in-network when possible, making sure to get referrals and pre- certifications as required by the plan.
-- Keep all receipts for medical services, whether in- or out-of-network. In the event you exceed your deductible, you might qualify for a tax deduction for out-of-pocket medical bills.
-- Consider opening a flexible spending account (FSA), if your employer offers one, which allows you to set aside pre-tax dollars for out-of-pocket medical expenses.
Tips to Help Consumers Lower their Life Insurance Premiums
-- Keep in mind that life insurance premiums generally increase with age.
-- Stay healthy or get healthy. Insurance companies might review your health habits and will consider certain behaviors, like smoking or excessive drinking, when determining your premiums.
-- Avoid risky behaviors. Dangerous hobbies -- such as skydiving, hang- gliding or rock climbing -- will likely cause higher insurance premiums.
-- Maintain a good driving record. The better your driving record, the better rates you'll receive for life insurance.
"Insurance is one of the easiest ways that consumers can protect themselves against significant financial loss, especially during difficult economic times," said NAIC Acting Executive Vice President and CEO Andrew Beal. "It's also important that consumers understand their insurance needs and options. We urge them to visit Insure U to learn more."
Available at www.insureUonline.org, the Insure U curriculum provides an introduction to the four basic types of insurance -- auto, home, health and life -- along with tips and special insurance considerations for eight life situations. The curriculum also provides information about how to avoid being scammed by fake insurance companies selling fraudulent insurance policies. Disaster preparedness and long-term care insurance tips are also included. After reviewing the curriculum, consumers can elect to take a short online quiz. Upon successful completion of the quiz, consumers can print out an Insure U diploma.
For more information:
-- Call the NAIC's toll-free hotline -- 866-470-NAIC (6242) -- to find out how to contact your local insurance department.
-- Visit www.naic.org/state_web_map.htm to link to your local insurance department's Web site.
-- Visit www.insureUonline.org for additional tips specifically geared toward a variety of life situations.
About the NAIC
Headquartered in Kansas City, Mo., the National Association of Insurance Commissioners (NAIC) is a voluntary organization of the chief insurance regulatory officials of the 50 states, the District of Columbia and five U.S. territories. The NAIC's overriding objective is to assist state insurance regulators in protecting consumers and helping maintain the financial stability of the insurance industry by offering financial, actuarial, legal, computer, research, market conduct and economic expertise. Formed in 1871, the NAIC is the oldest association of state officials. For more than 135 years, state-based insurance supervision has served the needs of consumers, industry and the business of insurance at-large by ensuring hands-on, frontline protection for consumers, while providing insurers the uniform platforms and coordinated systems they need to compete effectively in an ever-changing marketplace. For more information, visit www.naic.org/press_home.htm.
By OMAR FORD
Medical Device Daily Staff Writer
A new study, titled "Chronically Ill and Uninsured: A National Study of Disease Prevalence and Access to Care in U.S. Adults," published in the Aug. 5 edition of Annals of Internal Medicine, shows that more than 11 million Americans with chronic physical illnesses aren''t getting the medical care they need because of a lack of health insurance. Authors of the study say that this is the one of the first real studies that provides a national estimate of the number of uninsured adults with these potentially serious but treatable conditions.
According to the report, working-age adults with one or more chronic illnesses who reported they were uninsured were nearly four times more likely than their insured counterparts to have not seen a health professional within the past year (22% vs. 6.2%). They were also six times more likely to identify a hospital emergency room as their standard site for care when sick-which is a huge problem in itself, according to Andrew Wilper MD, the study''s lead author.
Wilper, who currently teaches at the University of Washington School of Medicine (Seattle), was a fellow at Harvard University (Cambridge, Massachusetts) and the Cambridge Health Alliance when the study was carried out.
"What I fear happening is these people who are uninsured are forced to rely on the Emergency department and it''s a different kind of therapy-specifically for emergencies," Wilper told Medical Device Daily. "The ideal place to get medical care is from physicians, who''re familiar with your records, and your past history. That''s not what the emergency room is designed to do."
Steffie Woolhandler, MD, a co-author of the study, and an associate professor of medicine at Harvard and a primary care physician in Cambridge, Massachusetts, added that "Some claim that uninsured Americans can get the care they need in emergency rooms. But 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."
Instead, what often happens is the snowball effect, and potentially manageable illness turns into a chronic illness.
"Most of the conditions are treatable, and can be well controlled," he said. "There are a lot of people that have treatable medical conditions. But they are locked out of having a quality standard of healthcare. Some plans, for example, require people to pay medical bills of $5,000 out-of-pocket before their insurance kicks in. These plans put people in the precarious state of being underinsured, which is not that much better than lacking health insurance altogether."
Of those illnesses, hypertension and high cholesterol ranked high above them both.
For a little more than a year Wilper''s team analyzed data from surveys conducted by the National Center for Health Statistics. The team found that there are 11.4 million non-elderly adults with one or more chronic conditions who lack health insurance, including 1.3 million who survived a heart attack or stroke, 5.9 million with high blood pressure, 1.4 million with diabetes, and 3.5 million with asthma or emphysema.
Individuals with at least one of these conditions, or with high cholesterol or prior cancer (excluding minor skin cancers), were considered to have a chronic illness.
The 11.4 million figure represents about one-third of the total number of uninsured people in the U.S. between the ages of 18 and 64. Altogether, about 47 million Americans lacked health insurance in 2006, according to the U.S. Census Bureau.
The authors say they may have underestimated the number of chronically ill persons who lack insurance because the survey did not query participants about depression or other chronic mental illnesses, and because undiagnosed physical diseases among the uninsured may be common.
For the past year, presidential candidates have been touting healthcare plans, and the number of 46 million uninsured Americans has been etched in people''s minds.
In June the Senate grappled over healthcare reform, saying that virtually any sweeping changes are likely to boost, not trim, the cost of healthcare in the U.S. in the early going (Medical Device Daily, June 17, 2008). Prior to that during a Chronic Care Congress Meeting just outside the nation''s capital, panelists at a discussion called "Should Retail Clinics Manage Chronic Disease?" cited that three-fourths of all U.S. healthcare expenditures are for chronic diseases (MDD, June 4, 2008).
"We need some way of having non-profit health insurance to get everyone insured," Woolhandler told MDD. "That''s what we''re seeing most countries do. You can't pretend there''s some cheap and easy way to mandate healthcare."
By TOM MURPHY, AP Business Writer
Mon Aug 11, 11:16 AM ET
But that increase is the smallest Aon has seen in six years. Experts say it shows that efforts to tame costs, such as employee wellness or disease management programs, may be paying off.
"There's a variety of tactics that employers have been employing over the last 3 to 6 years that has had an impact on the market," said study director Bill Sharon, an Aon Consulting senior vice president.
Aon Consulting surveyed about 70 health insurers around the country, including companies such as Aetna Inc. and Cigna Corp. It found that actuaries expect costs to rise an average of 10.6 percent during 12-month rating periods starting this year between April and September.
That represents a slight drop from last year's forecast of 10.9 percent and a bigger fall from 2002, when health care costs were expected to rise by more than 16 percent.
But the percentage likely won't be what the average employee faces for a premium hike next year. It doesn't reflect insurance plan designs or changes an employer might make to benefits plans.
"Pretty much every employer has to do something or is doing something in an effort to bring that number down," Sharon said.
He said actual cost increases have wound up being three to four percentage points lower than preliminary estimates in the past couple of years. Still, he said Aon Consulting's survey gives employers a benchmark to use as they consider premium renewals.
Many employers have started researching their benefit options for 2009. Consultants say it's too early for predictions on next year's health care plan costs.
But Ken Ambos of Equity Risk Partners Inc. said midsize employers could see a cost increase of roughly 9 to 12 percent that they pare down to 6 to 9 percent. Equity Risk Partners is a risk management and employee benefits consulting firm
Costs are still rising to keep up with growing patient demand for services, the needs of an aging population and prescription drug and technology costs, according to Aon Consulting, a subsidiary of Aon Corp.
Overuse and misuse of services and an "out-of-control medical liability system" also contribute to increases, said Robert Zirkelbach of America's Health Insurance Plans, a trade association representing nearly 1,300 insurers.
"It is encouraging that the growth in health care costs is going down, but there is still more work to be done," he said.
Zirkelbach said health insurers have offered disease management programs and encouraged the use of cheaper generic drugs to help contain costs.
Employer wellness programs also have played a role, Sharon said. He noted that doctors, hospitals and employers all have worked to curb costs.
"When costs go up as great as this, there's a lot of market pressure brought to bear on all of the parts of the market to bring those costs down, and I think that's what's been happening over the last six years or so," he said.
Aon Consulting has forecast a steady decline in cost increases since 2002. But Sharon said this decline has grown smaller the past few years, a sign the reductions may be bottoming out.
provided byBusinessWeek
by Anne Tergesen
Early retirement, a dream of many, can turn into a nightmare for those forced to buy their own health insurance. Too young for Medicare, early retirees who can't get coverage through a spouse often must fend for themselves in the market for individual policies. But insurers turn down about 30% of applicants ages 60 to 64, and those they accept often pay exorbitant premiums. "This is not a group anyone really wants to cover," says Sara Collins, assistant vice-president at Commonwealth Fund, a health-care policy foundation in New York.
From 1993 to 2007 the percentage of large companies offering health insurance to early retirees fell from 46% to 31%, according to Mercer, a New York consulting firm. The reason? Since 1993, accounting rules have required companies to deduct the estimated future cost of retiree health benefits from profits, an amount that for many is greater than the pay-as-you-go method corporations had previously used.
More from BusinessWeek.com:
- Quiz: Are You Retirement Ready?
- How to Enjoy a Scam-Free Retirement
- Will You Outlive Your Money?
But there are signs the benefit may be staging a comeback-though only among the largest employers. An initiative introduced by insurer Aetna and a group of major companies on Jan. 1 is expanding early retirees' access to coverage. Under the plan, called Retiree Health Access, several employers are banding together to help their retirees, pre- and post-65, buy insurance at discounted group rates. While the employers don't have to kick in a subsidy, more than half now do. "With a greater mass of people, we should be able to drive costs down," says J. Randall MacDonald, a senior vice-president of human resources at participant IBM.
Of the 32 companies on board, 15 are providing benefits for early retirees for the first time, according to the nonprofit HR Policy Assn., whose 250 members-all big corporations-are eligible to join. "It's very significant," says Paul Fronstin, director of the health research and education program at the Employee Benefit Research Institute.
Insurers traditionally steered clear of early retirees-forcing companies to dig into their own pockets to cover claims. Cigna, WellPoint, and others are now rolling out plans designed to give employers a way to provide insurance without necessarily spending a lot on the premiums. Why the sudden interest? With boomers approaching retirement, insurers sense opportunity: At 65, early retirees become eligible to buy lucrative policies that supplement or replace Medicare. "We want to cover them for the rest of their lives," says Kenneth Sperling, senior vice-president at Cigna's Senior & Retiree Services.
Retiree Health Access offers four options for early retirees. All foot the bill for preventative care. Al Rapp, corporate health-care manager for participant United Parcel Service, says the coverage is more affordable than what's available under UPS's existing retiree health plan, which UPS offers alongside RHA. In return for lower premiums, the RHA plans shift more responsibility for paying medical bills to retirees through features including higher deductibles, he adds.
Like RHA, the other new plans seek to hold costs down by creating large pools of early retirees. To prevent retirees from jumping in only after becoming ill-a move that drives costs up-insurance companies often offer just one chance to enroll. So far, RHA is the only one to funnel retirees from several companies into one big insurance pool. But, says Jeff Verney, CEO of UnitedHealthcare's United Retiree Solutions, "That's something all of us are thinking about."
By offering these benefits, companies earn goodwill with employees while also creating an incentive for older workers-who may be burned out or more expensive than potential replacements-to leave the payroll. According to Mercer, those with company-provided coverage retire, on average, at age 61; those without benefits tend to hang on until age 63.
When such plans are offered, employees who qualify-typically, anyone 50 or 55 to 64-are guaranteed coverage, no matter what their health status. And while insurers can raise premiums for the entire group, an individual who racks up a lot of bills won't be singled out for a rate increase.
The still-unanswered question for workers considering early retirement is whether these new benefits will prove to be affordable. Under the RHA plan, for example, premiums can range widely, from $400 to more than $1,000 a month, with annual deductibles of $250 to $3,700. The variation depends in large part on whether an employer provides a subsidy-which could determine whether or not someone's wish to retire early can become a reality.
Tergesen is an associate editor for BusinessWeek in New York.
