US: One in three skip medical care because of cost

The US health care system is failing even those who have insurance, an unprecedented 26,419-person survey sponsored by the AFL-CIO and Working America confirmed today. One in three say their families had to skip medical care because of cost, a quarter had serious problems paying for the care they needed and a huge majority–79 percent–says health care is a top voting issue. The survey results, one of the largest opinion pools available on health care, includes 7,500 personal stories and were conducted between Jan. 14 and Mar. 3, 2008. Of the more than 26,000 people who took the survey, most are insured and employed. Most are college graduates. More than half are union members. "These are the people you would expect to have positive experiences with America's health case system…the lucky ones–except they're not," said John Sweeney, president of the 10 million member AFL-CIO. "They're hurting... struggling to pay medical bills, skipping doctor visits and prescriptions because of costs... and they are extremely pessimistic about the future of our country. They think health care is one of today's most important issues–and they are ready to vote about it," Sweeney said. Health care concerns voters of all ages. Seventy-four percent of the 18-29 year olds who took the survey count health care a very important voting issue, as do 80 percent of 50- to 64-year olds. Ninety-five percent of respondents overall–including 94 percent of the insured–say health care in America needs fundamental change or to be completely rebuilt. More than half of people in insured families say their insurance does not cover all the care they need at a price they can afford. Despite having insurance, they report not being able to afford prescription drugs, follow-up care and even preventive care, which are either not covered or covered insufficiently. People who buy their own insurance in the private market are more likely than those with employer-provided health care to report that critical needs are not covered or not affordable. One-third of college graduates report they or a family member skipped medical care because of cost. Forty-six percent of respondents report having to spend between $1000-$5000 out of pocket for health care in the last year, and another 17 percent spent more than $5000. Problems are also reported by Medicare recipients, 53 percent of whom say their prescriptions are not covered or are unaffordable, despite the much hyped PART D legislation that was supposed to change that. People who lack insurance–and those who have children younger than 18 who are not covered–report particularly troubling problems getting the care they need because of cost. In the past year, 76 percent of people who lack insurance themselves and 71 percent of people with uninsured children say someone in their family did not visit a doctor when sick because of cost. Fifty-seven percent of the uninsured and 61 percent of people with uninsured children had to choose between paying for medical care or prescriptions and other essential needs (such as the rent or mortgage and utilities). The failures of the US health care system, the survey reveals, are a significant factor in the pervasive economic distress facing working families today: Eighty-three percent of respondents say their families "have just enough to get by" or are "falling behind." 84 percent predict the standard of living will be even worse for the next generation. Nearly half of the respondents (48 percent) and 60 percent of Latinos say they or a family member has stayed in a job just to hold on to health care benefits. Families are also worried about the future: 95 percent are "somewhat" or "very" concerned about being able to afford health insurance in the coming years. Almost two-thirds (61 percent) of respondents with employer-provided coverage say their costs have gotten worse in the past couple years. "What would you do if you had to choose between food or medicine?" wrote Marie, from Madison, WI. "I work full time and have health care through my employer, but only a percentage is paid by them.... I recently needed medication, but did not get the medicine. I couldn't.... What would I choose? I choose my children and what they need..." Health care quality is also a big concern. People of color, including 75 percent of African Americans and 76 percent of Latinos, are especially likely to voice dissatisfaction with health care quality, as are 64 percent overall. The AFL-CIO and its community affiliate, Working America, launched the seven-week survey in January to better understand the landscape of the health care crisis in America and provide that information to candidates running for public office in 2008.