79 Million Americans Struggle to Pay Medical Bills

New numbers show the problem is getting worse, not better, even for middle class

WEDNESDAY, Aug. 20, 2008 (HealthDay News) -- Working-age Americans are facing mounting problems when it comes to affording health care, a result of what analysts are calling a "perfect storm" of economic woes.

In 2007, 41 percent of working-age Americans -- 72 million people -- reported having medical bill problems or trouble paying off medical debts, up from 34 percent in 2005.

Another 7 million adults over 65 had similar problems, bringing the total to 79 million adults struggling to pay health-care bills, according to a new study from The Commonwealth Fund, Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families.

"These findings provide further evidence that the health system is falling short of where it needs to be to ensure health and economic security," Karen Davis, president of The Commonwealth Fund, said at a Tuesday teleconference. "We need a new administration to make universal and affordable health insurance available," she said.

Also unsettling is the fact that adults in more income groups are being affected.

"What is notable is how this is spreading up the income scale," said Commonwealth Fund assistant vice president Sara Collins.

The survey, based on telephone interviews conducted between June 6 and Oct. 24, 2007 with 3,501 adults aged 19 and older in the continental U.S, found problems across multiple fronts:

  • In 2007, nearly two-thirds of U.S. adults under 65 (116 million people) reported having problems with medical bills or debt, having put off needed care due to cost, or being uninsured or underinsured and consequently having high out-of-pocket medical costs relative to their income.
  • Although such problems were seen across the board, they were particularly pronounced among low- and moderate-income families. More than half of adults earning less than $40,000 annually reported problems paying medical bills or being in debt as a result of health care expenses.
  • Thirty-nine percent of people with mounting bills or debts said they had depleted their savings to pay off bills; 29 percent were having problems paying for food, heat, rent and other basic necessities; and 30 percent had accumulated credit card debt.
  • Many are also foregoing medical care, including medications: 45 percent of adults reported problems getting care because of rising costs (up from 29 percent in 2001).
  • One-third of respondents reported spending 10 percent or more of their income on medical costs, including premiums, in 2007, up from 21 percent in 2001.
  • About one-quarter of working-age adults with medical debt owe $4,000 or more while 12 percent owe $8,000 or more in medical expenses.
  • Twenty-eight percent of working-age U.S. adults (about 50 million people) were uninsured for at least part of 2007, up from 24 percent in 2001.
  • Fourteen percent of working-age adults (25 million people) were underinsured, up from 9 percent in 2003.
  • Sixty-one percent of those with medical bill problems or accumulated medical debt were insured at the time care was provided. "Even adults with insurance reported problems in getting needed care," Collins noted.

Americans were experiencing the burdens outlined in the survey during a time of relative economic levity, the researchers pointed out. "Even in 2007, when the economic slow-down hadn't really taken hold, you found that 29 percent of those with medical bill problems or accrued medical debt reported being unable to pay for basic necessities like food, heat, rent," Davis said.

More information

For more on the findings, head to The Commonwealth Fund.

SOURCES: Aug. 19, 2008, teleconference with Karen Davis, president, The Commonwealth Fund. and Sara Collins, assistant vice president, The Commonwealth Fund; Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families
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