Health insurance issues
1. How many Californians have no health
insurance?
According to 2003 statistics, 6.6 million Californians
did not have health insurance for the year. Of these, 3.7 million
had no insurance for the entire year, and nearly one million children
were uninsured for all or part of the year.[1]
2. Who does not have health insurance?
More than 80 percent of Californians who lack
health insurance are in families where at least one person works.
A disproportionate number are from Black and Hispanic communities,
and more than 20 percent of children have no health insurance. The
uninsured are both low-wage workers and workers with higher incomes.[2]
3. Do most people who work have health insurance?
Working adults and/or their dependents make
up 76 percent of California's uninsured residents.[3]
Employment-based coverage is declining as employers find they can
no longer afford the rapidly rising costs of insurance premiums. More
employers who do offer insurance are passing on more of the cost to
their employees.[4]
4. How do the uninsured get health care?
Many uninsured get limited health care in emergency
departments. A study finds that uninsured visits to emergency departments
increased by about 10 percent while visits to physician offices by
uninsured persons declined 37 percent.[5]
Higher caseloads and lower reimbursements from public and private
payers have compelled many medical practices to limit care provided
to uninsured patients.
Further, the uninsured do not get the care they
need on a regular basis, which includes primary and preventive care
and prescription drugs. The uninsured with chronic illnesses cannot
get regular monitoring and the medication adjustments that they need
to stay as healthy as possible. Those with diabetes or asthma often
end up with unnecessary, expensive and often tragic complications.
Without proper disease management, diabetes can lead to heart disease,
blindness, kidney failure and amputation of limbs.[6]
5. What is meant by "under-insured"?
When people who have health insurance need treatment
that is excluded as a pre-existing condition, they are under-insured.
When expensive pharmaceuticals, which are life giving or necessary
for care quality, are not covered by insurance, the insured is under-insured.
Insurance companies also place an annual cap on the amount they will
pay per person or family for covered services. Those with extensive
medical expenses often do not have enough insurance coverage for the
entire year and can become financially overwhelmed with health care
expenses. They also are under-insured.
Almost half of all personal bankruptcies in
the United States are the result of high medical bills.[7]
These bills were not covered because these people did not have insurance
or enough insurance or the right kind of insurance. Nearly two million
Americans experienced medical bankruptcy in 2001 because of health
care bills incurred when they or a family member became seriously
ill.[8]
Further, 76 percent of people who had a medically related bankruptcy
had health insurance when they first became ill.[9]
Bankruptcy due to medical costs for treating
illness is a rare occurrence in other developed countries.
