Nearly 6 In 10 People With Health Insurance Have Had Coverage Issue In Past Year
The US health insurance system is consuming both the insured and the uninsured, according to a study.
The US health insurance system is expensive, aggressively deters patients and denies access to coverage for millions of people, and is often ineffective even for most people with health plans, a study shows. new study.
About 6 in 10 adults with health insurance say they've had problems with their health insurance in the past year, according to a new nationally representative survey of 3,605 health insurance holders released Thursday by KFF . In most cases, problems arise with reporting employer-provided insurance and not with the marketplace or the government.
If the data is representative of the US population, that means that tens of millions (perhaps more than 100 million) of the roughly 300 million people with health insurance in the US are likely to have had health problems with insurance recently.
Key issues include insurance not paying as much as expected (27%), not being able to see a local doctor due to lack of prescriptions (26%), insurance not covering prescription drugs, or charging too high a copay ( 2. 3). . %). . or insurance that did not cover services that the patient thought were covered (18 percent). Other common issues have also been linked to denial of insurance coverage, such as denial or delay of pre-approval; You need to see a doctor, go to the hospital, or get mental health care that is not covered by insurance. or reach the visit limit your plan covers.
In another blame system, those who needed more care were more likely to have problems with their health insurance. Of those who had more than 10 visits in the past year, nearly 8 in 10, or 78%, said they had insurance problems. People who needed psychiatric care were also more likely to have problems: 74% had problems and 43% said they stopped treatment, probably due to poor insurance coverage.
Insurance plans are also often difficult to understand: A majority (51%) of insured adults say they find it difficult to understand any aspect of their health insurance, such as what the plan covers or how much they will pay out-of-pocket. Cautious.
"The survey shows that the sheer complexity of insurance is as much a concern as affordability, particularly for those who need it most," said Drew Altman, KFF President and CEO. "People report a number of obstacles due to denied requests, limited network providers and a maze of red tape, and many say it's not giving them the help they need."
Experts and progressive advocates have long said that the health care system in the United States is broken, often on purpose. Private health insurers often work behind the scenes to undermine seemingly valid claims, or have strange and unpredictable gaps in coverage that leave patients with high medical bills, such as when a patient goes to the hospital to see the treating doctor. His plan spreads, but he is seen in the hospital. a tool that does not exist. Meanwhile, people who may be uninsured due to layoffs or layoffs are constantly struggling financially or being forced to forego care due to expenses.
Thus, the US health care system has the worst health outcomes in most rich countries in the world, while being the most expensive system of any rich country in the world, as the United States is the only rich country without a health care system. According to a February Commonwealth Fund report, the United States spent more than $10,600 per capita on health care in 2021, nearly double the per capita spending of the top spending country.
But despite the inefficiencies of the current system, federal legislators and Congress cannot compete with their US counterparts in implementing universal health coverage because the large sums of money spent lobbying against Medicare for All are effectively an industry in its own right. .
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