The Rising Number of Uninsured or Underinsured in the Country - Research Paper Example

The rising number of uninsured or underinsured in the country Q1.For what period of time must someone be uninsured to be counted in that number? One qualifies to be uninsured if they spend 10% of more of their income or 5% for the low income earners on out of pocket medical costs, or in case they incur deduction the can be equaled 5% or more of their income for a period f one year (Hammaker et al, pg 11). Q2.What percent of those in that number have the assets to pay for care? Cases of underinsured not cared for were reported in the past. There have been problems in terms of access and financial stress for the underinsured population. Despite the fact that the insured have coverage, all year round the experiences are similar to those of the uninsured. More than half of the underinsured, which represented 53%, and two third of the uninsured which represents 68% did not have the opportunity to access the needed medical care. This included but not limited to not being able to seek doctors when ill, filling prescriptions also not following up on the recommendation tests or treatments made by the doctors. Among the insured, a meager 31% went without such care. When it comes to financial difficulty and access problems, the underinsured who have coverage all year reported similar experiences as the uninsured. 53% which represented more than half of the underinsured and two thirds of the uninsured which was 68% went without the needed care including, but not limited to seeing a doctor when unwell, not filling prescriptions, and not being able to make a follow-upon the recommended tests or treatments as directed by the doctor. A meager 31% of the insured population went without such care. Nearly half of the underinsured represented by 45% and uninsured represented by 51% reported difficulty settling their bills, the led to contact by collection agencies for unpaid bills, or changing their lifestyle in order to settle outstanding medical bills. Some confessed of taking loans, mortgages against their home, credit card debt to settle their accrued medical bills. This is a clear suggestion of the financial difficulties they faced with the capability of creeping in the future, on the contrary only 21 % of insured reported the financial stress linked to medical bills (Wilson and Andrew, pg 27). Q3.What number and percent of Americans have insurance? Those who are underinsured, that is people with health covers, which does not, properly or fully protect them from high medical cost in the U.S has risen immensely. This is according to the commonwealth fund study. For the year 2007, the number of underinsured were estimated at 14% of all the nonelderly adults, with more than a quarter uninsured for all or part of the year. Addition of these two groups gave a total of 75 million which represented 42% of the under 65 years population without insurance or insufficient insurance in 2007, up from 35% in the last three years (Sultz et al,pg 03). Most of people in this group come from the middle class families. As those from low income families remaining vulnerable, those from the middle class families being affected the most. This was evident from an analysis from families which earns approximately 40,000$ per annum almost tripping in the last three years. Q4.What has been the trend for the number of those WITH insurance over the past 2-3 years? According to Hammaker et al, (pg 96).he number of those having insurance cover has been on a downward trend. This has been attributed to undesirable effects of increased cost-sharing on patient access to on time care that can be tricky for the low income families. Plans seldom adjust cost exposure based on earnings. Combination of poor health and low income inflate the risk of access barriers and financial stress. The number of uninsured in the US have adopted a downwards trend because of the following highlighted factors. The factors include, but restricted to, welfare reforms which initiatives that have minimized the ability of many jobless, low income individual to access Medicaid coverage. Low income earner may not afford health insurance due to unemployment, because their employer does not cater for insurance as a benefit of employment, because they cannot pay for it. Even for those who have insurance cannot get the services they need because of the needs related to cost sharing (Wilson and Andrew pg. 54). Approximately 35% of adults in the US are either underinsured or uninsured. These two groups are more likely to forgo the needed care than those with adequate coverage. This is because rates for financial stress for the two groups that are underinsured and uninsured are same. With the ever increasing numbers of underinsured and uninsured citizen, the burden of caring for this group of individuals is left to the state universities, community health clinics and other government supported health institution. Generally, these studies illustrate that there is the need to proceed with vigilance when changing the plan of health insurance strategies to evade putting patients, particularly the poor and sick in increased financial stress (Wilson and Andrew pg. 97). Q5.Why are these people considered to be uninsured or underinsured, meaning why do they not buy health insurance or receive government benefits: who fits the criteria to be counted in this number? A perfect definition of underinsured individuals refers to this group of individuals who are insured all year round but has any of these qualifiers; medical expenses greater that 10% of yearly income, a yearly revenue total of less than 200% of the federal poverty level and medical costs more than 5% of annual income or health arrangement deductibles equal to or more than 5% of annual income (Sultz et al, pg 107). In comparison to the satisfactorily insured adults, the underinsured are entitled to restricted access to care similar to the uninsured. In the year 2003, more than 16 million people aged between 19 and 64 years were underinsured with additional 45 million people uninsured (Hammaker et al, pg 06). Q6.Should those who pay taxes and provide their own health insurance be forced to pay for the care of those who do not? Or forced into a different system altogether to benefit those people? What else might be done to more effectively help those who are uninsured or underinsured besides changing the entire system? Or is that the only answer All the above suggestions can not be practical at any point. The only way is to formulate policies which can incorporate the low income earners in order for them to benefit from the insurance scheme. Concerns about inadequate insurance can contribute greatly towards reducing the problems associated with financial stress and access of medical services. There is still loophole as concerns uninsured among the young population in the U.S. policy maker ought to address the upward trend of the uninsured and underinsured people in the country through conducting regular national updates on the number of underinsured Americans. People with limited or no healthcare insurance go through difficulties accessing care, this leaves them fumbled on type of health care offered. Effort of introducing cost sharing has proven fruitless as it did not entail a check on the downsides of a similar approach. Redesigning the insurance industry policies will be the way out of insurance nightmare for the low income families (Hammaker et al, pg 96). Conclusively, new policies need to be formulated. This helps addressing the current health insurance cost sharing designs and effects they have on the swelling numbers of underinsured patients. Attention should be paid to the adequacy of healthcare insurance and effectiveness of the care patients receive. Having policies with considerable cost-sharing comparative to income will destabilize access to care and grind down family funds. The main goal should be quality care and improved outcomes and not just coverage (Sultz et al,pg 24). Work cited Hammaker, Donna K., and Sarah J. Tomlinson. Health care management and the law: principles and applications. Clifton Park, NY: Delmar/Cengage Learning, 2011. Print. Wilson, Andrew L.. Financial management for health-system pharmacists. Bethesda, Md.: American Society of Health-System Pharmacists, 2009. Print. Sultz, Harry A., and Kristina M. Young. Health care, USA: understanding its organization and delivery. 5th ed. Sudbury, Mass.: Jones and Bartlett, 2006. Print. Read More