People who have insurance keep paying more for it, survey says

Insured workers pay an
average of $3,281 for their share of the premium.

SCRIPPS HOWARD

The news from the U.S. Census Bureau that almost 1 in 6 Americans lacked health insurance during at least part of last year made big headlines a few weeks back.

But other research shows that things aren’t rosy for many of the 253 million people who do have health coverage.

For one thing, we continue to pay more for health insurance, both directly and indirectly.

Premiums for health insurance through work — the kind that covers 153 million of us — rose an average of 6.1 percent this year, down from 7.7 percent last year, but still ahead of the 3.7 percent increase in wages and overall inflation of 2.6 percent, according to an annual survey of costs released Tuesday by the Kaiser Family Foundation and the Health Research and Educational Trust.

The survey found the average premium for family coverage is $12,106 per year, and workers now pay an average of $3,281 to cover their share of the policy. To put the numbers in perspective, someone working 40 hours a week at the new federal minimum wage of $5.85 an hour earns $62 a year more, before taxes, than the average cost of covering a family.

“We’re seeing some moderation in health-cost increases, but there’s a cumulative effect that makes health insurance less affordable for families and businesses every year,” said Kaiser president Drew Altman. “Over the past six years, the amount families pay out of pocket for their share of premiums has increased about $1,500.”

Effects of health costs

Researchers know health costs are depressing wages and affecting hiring decisions in many companies. Smaller firms, in particular, are reluctant to offer any health coverage. Overall, only about 60 percent of workplaces in the country have a health-plan option at any price, down from 69 percent at the start of the decade.

And many with coverage don’t feel secure. A survey done for Consumer Reports this spring and published this month found that 24 percent of people age 18 to 64 with health coverage said the plans were so skimpy they didn’t adequately cover costs of prescriptions, doctor visits or tests, or they felt the deductible was too high and catastrophic coverage too low.

Forty-three percent of the “underinsured” said they put off going to the doctor due to costs; 28 percent said they delayed filling a prescription. Overall, 43 percent of people with insurance said they were “somewhat” or “completely” unprepared to deal with a costly medical emergency in the coming year. And the median household income for this uninsured group was $58,950, well into middle-class territory.

People without insurance, of course, don’t go entirely without health care. Some pay for everything out of their own pocket, some rely on charity care and many others run up medical debt. But like the underinsured, they’re likely to skip routine care and put off seeking medical attention until they’re seriously ill — and more likely to need more expensive care that may put them deeper in debt.

We all pay

Health-policy researchers know that a lot of the costs of the uninsured gets passed along to society in the form of higher taxes for government-subsidized care and higher premiums to cover medical bills padded to account for the no-pays. That’s probably also a concern with the underinsured.

But one last study, out this week in the journal Health Affairs, shows that having a large share of a community’s population lacking health insurance also spills over into the quality of care offered everyone living there.

Economists Mark Pauly of the University of Pennsylvania and Jose Pagan of the University of Texas-Pan American compared survey results for health quality among nearly 10,000 people with health insurance living in two types of communities: one had a lot of uninsured, 27 percent of adults; the others lived in areas where only about 7 percent of adults lacked coverage.

They found that in the locales with many uninsured, the insured patients were about 10 percent less likely to say they had a regular source of medical care and also were less likely to have seen a doctor in the past year and more likely to have trouble getting referred to a specialist. “Those who live in communities with high rates of uninsurance face not only the higher costs related to uncompensated and charity care, but also lower-quality care,” Pauly said. “It’s in their self-interest to be willing to pay to make a change [for the uninsured].”