New Report Shows Big Health Care Gaps Between Uninsured and Insured with Chronic Problems

People with most common and serious conditions affected

WASHINGTON, D.C.-Millions of Americans who suffer from five of the most common chronic health problems face vast disparities in the care they receive depending on whether or not they have health insurance, according to a new report by Families USA, the national organization for health care consumers.

The report is the first analysis of differences in health care received by uninsured and insured people with heart disease, hypertension, high cholesterol, arthritis, and chronic back pain.

Compared to their insured counterparts, the report states, uninsured people with these health conditions: receive half the number of lab tests; are much more likely to go without medicines essential to maintaining health; obtain far fewer screenings for high blood pressure or cholesterol; depending on the condition, make 19 to 28 percent fewer visits to physicians' offices, clinics, and other outpatient settings; and are three to four and one-half times as likely, depending on condition, to have been unable to obtain care due to affordability problems. [A detailed summary of the report's findings, condition-by-condition, is attached.]

Heart disease is the number one cause of death in America. Stroke is number three, and hypertension and high cholesterol are significant risk factors in both these diseases. Arthritis, which afflicts over 40 million Americans, is the leading cause of disability in the United States, and chronic back conditions are the leading cause of activity limitation for Americans under the age of 45.

"Contrary to popular myth, this report shows that uninsured people receive much less care than those who have health insurance," said Families USA executive director Ron Pollack. "Unfortunately, these differences are enormous for the many millions of Americans afflicted with potentially life-threatening or disabling health conditions."

Among the report's findings are:

• Uninsured people with arthritis are more than five times as likely to receive no prescriptions of any kind as their insured counterparts.
• Among people diagnosed with high blood pressure, the uninsured were more than twice as likely to have had no blood pressure check in the past year.
• Uninsured people with heart disease have 28 percent fewer visits to physicians' offices, clinics, or hospital outpatient centers than insured people with heart disease.
• Among those with hypertension and arthritis, the uninsured are more than three and one-half times as likely as the insured to lack a usual source of care.

For people with heart disease, one-quarter (26 percent) of the uninsured, compared to seven percent of the insured, report that they or a family member did not receive care due to cost - a more than three and one-half-fold difference.

"The findings in this report should be a clarion call for quick and effective public action to expand health coverage to working Americans who can't afford insurance," said Pollack.

The new report is based on national data developed for the U.S. Department of Health and Human Services (HSS). The data are derived from the Medical Expenditure Survey (a national survey of 10,000 families and 24,000 individuals conducted by the Agency for Healthcare Research and Quality of HHS) and the National Health and Nutrition Examination Survey (a national survey of 40,000 people, including 20,000 people between 17 and 65 years of age, conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention of HHS). The data were analyzed by Families USA and The Lewin Group, an international health-consulting firm.

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Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans.

1201 New York Avenue NW, Suite 1100 · Washington, DC 20005
202-628-3030 · Email: info@familiesusa.org · www.familiesusa.org