More
people In U.S. dealing with financial burden of
health care costs
Newswise — An estimated 50 million people younger
than 65 years in the U.S. live in families that
spend more than 10 percent of their family income on
health care, an increase of more than 10 million
people in the past decade, according to a study in
the December 13 issue of JAMA.
Health care costs have been rising faster than the
rest of the U.S. economy for many years.
Out-of-pocket payments for health care services by
patients increased from $162 billion in 1997 to $236
billion in 2004, according to background information
in the article.
Although health care expenditures are consuming a
larger share of the U.S. gross domestic product, it
is not clear to what extent health care expenditures
are also consuming a larger share of family budgets.
This information could help policymakers understand
the impact of their policies and inform the debate
on where to target additional subsidies.
Jessica S. Banthin, Ph.D., and Didem M. Bernard,
Ph.D., of the Agency for Healthcare Research and
Quality (AHRQ), U.S. Department of Health and Human
Services, Rockville, Md., examined the net impact of
various trends in costs and coverage and changes in
benefits on the percentage of family income devoted
to insurance and medical care expenditures among the
nonelderly population. The researchers analyzed data
from the Medical Expenditure Panel Surveys of 1996
and 2003, which are nationally representative
samples of U.S. individuals younger than 65 years,
to calculate 2 measures of financial burden as a
function of tax-adjusted family income. Sample sizes
were 19,022 persons in 1996 and 28,970 persons in
2003. Total burden included all out-of-pocket
expenditures for health care services, including
premiums. Health care services burden excluded
premiums and, when applied to the insured
population, was used to identify the underinsured,
which was defined as insured persons with health
care service burdens in excess of 10 percent of
tax-adjusted family income.
"We found that the prevalence of high financial
burdens increased across the population as a whole
and among several subgroups between 1996 and 2003,"
the authors write. By 2003, there were 48.8 million
individuals (19.2 percent of the population) living
in families that spent more than 10 percent of
family income on medical care, an increase of 11.7
million persons since 1996. Of these individuals,
18.7 million (7.3 percent of the population) lived
in families spending more than 20 percent of family
income on medical care in 2003.
In 2003, individuals with higher-than-average risk
of incurring high total burdens included poor and
low-income individuals and those with nongroup
coverage, age 55 to 64 years, living in a
non-metropolitan statistical area, in fair or poor
health, having any type of limitation, or having a
chronic medical condition.
"Our measure of health care service burden can be
used to identify the underinsured, i.e., insured
persons without adequate financial protection from
high out-of-pocket costs. By this definition, we
estimate that 17.1 million insured persons younger
than 65 years were underinsured in 2003, including
9.3 million persons with private employment-related
insurance, 1.3 million persons with private nongroup
policies, and 6.6 million persons with public
coverage," they write.