Uninsured And Chronically ill: The New American Health Risk

A new study shows that a third of Americans lacking insurance are also suffering from some chronic ailment, something that has the potential to degenerate into a lethal combination.

The study, conducted by a team that had as its lead Dr. Andrew Wilper, a medicine instructor at Seattle’s University of Washington, used data from interviews with almost 12,500 people aged between 18 and 64 years who had participated in the National Health and Nutritional Examination Survey (NHANES).

Dr. Wilper’s team consisted of physicians from Cambridge Health Alliance and Harvard Medical School. They were able to show through their study that an estimated 11.4 million working-age Americans having at least one of seven chronic medical conditions do not have health insurance.

The chronic illnesses that were in the ambit of the study include cardiovascular disease, hypertension, diabetes, asthma, high cholesterol, chronic obstructive pulmonary disease and cancer.

This is a dangerous state of affairs, as the uninsured do not have easy access to medical care, according to Dr. Wilper. He said, “The uninsured can’t get in to see the doctor, they miss medications, their blood pressure is out of control and, really, you see devastating consequences.”

Dr. Oliver Fein, president-elect of Physicians for a National Health Program and professor of clinical medicine and public health at Weill Cornell Medical College of Cornell University in New York City, agreed with Dr. Wilper. He said, “These people are going to end up with complications of their illnesses prematurely. They will be disabled early. They will probably die younger.”

“It is a major public health disaster. Longer-term, there will be expensive admissions to hospitals, usually through the emergency department, due to diabetes out of control and congestive heart failure because of hypertension," Dr. Fein added.

During the course of the study, a comparison between the ill, uninsured individuals, and their insured counterparts brought up an array of striking differences.

About 26 percent of uninsured people reported no standard site of care, as opposed to only 6.2 percent of the insured persons. More than 22 percent of uninsured individuals reported no health check-ups in the past year compared to 6.2 percent of insured people.

More alarmingly, 7.1 percent of uninsured people suffering from a chronic condition reported that the emergency room was their standard site of medical care, versus only 1.1 percent of those carrying insurance.

The new study corroborates the findings of an earlier one published July 22 in Health Affairs, which pointed to the deteriorating scenario in access to medical care among uninsured, non-elderly U.S. adults with chronic conditions.

The report of the study was published in the August 5 edition of Annals of Internal Medicine, a prominent medical journal.