Miranda Yaver, PhD
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Follow-Up On underinsurance crisis

3/20/2016

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Ironically writing while being treated in the American healthcare system (I like to think of it as "field work" on American hospitals and insurance... as any politician can tell you, it's all about the framing), this article from the American Journal of Managed Care speaks directly to my previous post on the prevalence of underinsurance in American health care:

"Today’s health insurance marketplace is brimming with 17 million newly insured individuals, including those covered directly by the Medicaid expansion or the marketplace provisions of the Affordable Care Act (ACA) and those newly enrolled in an employer plan. Although the expansion of insurance coverage is a good thing for access and population health, specific features of the ACA coverage expansion have contributed to the rising number of underinsured individuals, defined by the Commonwealth Fund as people who have out-of-pocket healthcare expenses (eg, co-pays, coinsurance, deductibles) that account for 10% or more of their income, or at least 5% among those with lower incomes. Individuals with rare diseases, chronic conditions, or costly illnesses like cancer, who rely on specialty drugs, are even more likely to become underinsured, and this underinsured population is growing. A 2015 issue brief on the 2014 Commonwealth Fund Biennial Health Insurance Survey revealed that 23% of adults aged 19 to 64 were underinsured—that’s almost twice the 2013 rate. Our experience at the Patient Access Network (PAN) Foundation, an independent, national charitable organization that assists federally and commercially insured individuals living with chronic, critical, and rare diseases with the out-of-pocket costs for their prescribed medications, coincides with this finding. We have seen steady growth in patients’ need for financial assistance with the out-of-pocket costs of their medical treatments. In 2013, we assisted 99,271 patients, and in 2015, we assisted 364,385 patients—a 267% increase in just 2 years. Further, the amount of assistance PAN provides to individual patients has nearly doubled in the last 2 years."

The Patient Access Network (PAN) is an independent 501(c)(3) organization committed to addressing these very challenges of underinsurance, particularly in those with rare and chronic diseases that require that they draw heavily on their insurance benefits as well as their bank balances to cover the remainder. (Interesting, though somewhat distressing note on this: Hospitals have taken to running credit checks on patients' ability and likelihood of paying their hospital bills. While such credit checks are supposedly for informational purposes and not used to make decisions whether or how to treat a given patient -- they are obligated to provide treatment -- it adds an interesting level of transparency to the monetary aspect of healthcare provision in the United States). $0.95 of every dollar donated to PAN goes directly toward helping helping patients to afford needed medical care. This is not a Democrat issue or a Republican issue. It is a human issue. If you're in the camp of voters dissatisfied with options in both parties, consider donating here instead. I can almost ​guarantee karmic rewards.
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    Author

    Miranda Yaver is a political scientist, health policy researcher, and comedian in Los Angeles. She received her PhD in Political Science at Columbia University in 2015. She has taught courses on American politics, public policy, law, and quantitative methodology at Washington University in St. Louis, Yale University, Columbia University, and Tufts University.

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