The challenge of health insurance

Navigating healthcare is a challenging proposition. When one considers the often necessary role of health insurance in accessing healthcare, it becomes increasingly complicated and challenging.

From previous studies, like those done by the Rand Corp. in the 1970s, we know that more generous the insurance didn’t appear to improve health except for the poorest of the poor – yet another reason why Medicaid matters. However, we know that health insurance does matter. From the CDC:

“Not having insurance has a greater impact among those adults who need healthcare the most. Delays in receiving healthcare can lead to poorer health and higher medical costs over time, especially for those individuals who already have health issues, including the approximately 40% of the U.S. population with one or more chronic diseases. About 60% of adults ages 18-64 with a disability who had recent gaps in the past 12 months in their insurance skipped or delayed care as well.”

Taking the importance of health insurance a bit further, consider the role that health insurance has on racial/ethnic disparities. Authors’ Lillie-Blanton and Hoffman reviewed evidence from “studies specifically designed to quantify the contribution of health insurance to racial/ethnic disparities in access.” From their paper in Health Affairs:

“The studies identified for this review provide compelling evidence that health insurance accounts for much of the variation in racial/ethnic disparities in access to a usual source of care. The issue is not whether either race or health insurance is independently associated with experiences in the health care system. The preponderance of evidence from credible research has shown that they are. Rather, the issue is whether and to what extent does racial/ethnic background interact with health insurance to affect a person’s access to care.”

We know that the issue of health insurance was at the center of the Patient Protection and Affordable Care Act (PPACA) where it is expected that  insurance coverage is extended to another 32 million people. And we know the states where individuals still need health insurance or have the greatest need for health insurance. As seen in the Kaiser slide, most of the country has areas where there are at least 20% of the population where there are individuals who have no health insurance.

Covering the uninsured and making healthcare insurance affordable remains a substantial problem.

A recent Kaiser Family Foundation survey found that the average annual premium for family coverage through an employer reached $15,073 in 2011, an increase of 9% over the previous year.

And even if you can afford health insurance, navigating the tricky terrain to find the plan that is within your financial limits can be tough.

In the following story, the second in our partnership with the Health & Justice project, healthcare professional Shirley Fohl does her best each day to help people navigate the often confusing process of finding affordable health insurance. (2 min, 56 sec, Music Credit: “Naptime” (ethan-davis) / CC BY-SA 3.0).

And again we hear how difficult it can be for families to find healthcare that they can afford. Since we know that overall healthcare costs continue to grow at an uncontrollable rate, the downstream impact of these rising costs will inevitably continue to impact our communities and their ability to afford healthcare and health insurance.

So again we are back to the importance of stories and the critical need for healthcare transformation.

From Wendell Potter:

“One of my favorite bumper stickers reads, ‘If you’re not outraged, you’re not paying attention.’ That’s sort of how I feel about the healthcare debate. If more Americans paid attention to the fate of neighbors and loved ones who have fallen victim to the cruel dysfunction of our healthcare system, they would see through the onslaught of lies and propaganda perpetrated by special interests profiting from the status quo.”

He  continues:

“It occurred to me recently that Americans are not sufficiently outraged because they either don’t hear these stories or, if they do, don’t believe how commonplace they are or that anyone they know could experience the same misfortune. Or they might hear that more than 50 million Americans don’t have insurance because they can’t afford it or, in many cases, can’t buy it even if they can afford it, but they don’t stop to think that real human beings make up that abstract 50 million figure.”

These are real people who are out there uninsured and in need of help. As our story today highlights, sometimes there are many other issues at play in finding healthcare insurance.

As we work towards changing healthcare, we must not lose sight of the role of health insurance and making coverage affordable for all.