Health Inc.

Lack Of Insurance Compounds Chronic Disease Burden

It's dangerous enough to deal with a chronic illness like diabetes or cholesterol. But Americans who don't have health insurance often have these conditions and don't even know it.

An old person folds hands.

Chronic health problems can lurk undetected for the uninsured. iStockphoto.com hide caption

itoggle caption iStockphoto.com

The result is that the uninsured often don't get the medical care they need to maintain their health, says a study just published online by the journal Health Affairs.

Researchers found that about half of all uninsured people who have diabetes (46 percent) or who have high cholesterol (52 percent) had no idea they had those diseases. By contrast, among the insured, only about a quarter were unaware when they had those chronic diseases (23 percent for diabetes; 30 percent for high cholesterol).

Dr. Andrew Wilper, who practices at the Veterans Administration hospital in Boise, Idaho, in a program affiliated with the University of Washington and is a co-author of the study, said there's sometimes a misperception that even people without insurance get the care they need to manage chronic illness. "I've read in the media multiple times that the uninsured do, in fact, have access to health care," says Wilper, "and I think that notion runs totally counter to my clinical experience and this data reflects the same."

Wilper and his co-authors, looked at a federal data from the physical exams of sixteen thousand Americans, under the age of 65.

Among the study's co-authors are two prominent advocates for a single-payer health care system: Dr. Steffie Woolhandler and Dr. David Himmelstein, both of whom teach at Harvard Medical School. Woolhandler said the "shocking" percentage of people with insurance who still go without discovery or treatment of chronic illness probably reflected high co-payments and deductibles that "often make care and medications unaffordable". In a press release with the report, she argued, "only single-payer national health insurance would make care affordable for the tens of millions of Americans with chronic illness."

An earlier study by the same researchers, published last month in the on line edition of the American Journal of Public Health, said that about 45,000 deaths a year can be attributed to a lack of health insurance—more than the deaths caused by kidney disease.

The government estimates 46 million people in America are without health insurance.

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