Medical Debt Rising Even as More Forego Health Care: Report

The number of U.S. adults who went without needed medical care increased in 2007, according to the 2008 National Scorecard on U.S. Health System Performance. Nonetheless, the percentage of adults with medical debt rose by 6 percent between 2005 and 2007.

According to the report, 37 percent of all U.S. adults went without medical care in 2007 because it cost too much.  However, 41 percent of adults reported having medical debt or problems with medical bills, up from 34 percent in 2005.

A major contributing factor is costly insurance premiums, which is rising faster than wages.  In 2007 just 25 percent of non-elderly adults are living in a state where group health insurance premiums averaged less than 15 percent of household income, the report said.  In 2003, 58 percent of non-elderly adults lived in a state where group health insurance premiums averaged less than 15 percent of household income. As a result, 75 million adults were either uninsured or underinsured during the year – an increase of 33 percent from 2003, the report said.

The report pointed to major inefficiencies in the U.S. health system, including duplicate medical testing, that contribute to higher costs of care.  In 2007, U.S. patients were three to four times more likely than patients in other countries to report having had duplicate tests or unavailable medical records or test results at the time of their appointment.  Meanwhile, health insurance administrative costs as a share of total health spending are 30 to 70 percent higher in the U.S. than in countries with a mix of private and public insurance systems.

The report is prepared for the Commonwealth Fund Commission on a High Performance Health System, a private foundation.  It updates the 2006 scorecard, which was the first comprehensive report to measure and monitor health care outcomes, quality, access, efficiency and equity in the United States.