The Ill and Uninsured Wait Till 65 To Receive Care
When uninsured adults with common chronic illnesses became eligible for Medicare, they saw doctors and were hospitalized more often and reported greater medical expenses than people who had had insurance. And their increased use of medical services continued at least until at least age 72, researchers are reporting today. Their study, published in The New England Journal of Medicine, is one of the first to follow a large group of people through that crucial time of transition from being ineligible for Medicare to receiving Medicare benefits. Participants were interviewed and surveyed about their health and medical care every two years until 2004. That allowed the Harvard researchers to ask what happened when people who had not had insurance suddenly could have their health care paid for by the federal government.The effect that emerged — a surge in the use of health care by those who were previously uninsured — was concentrated in people with cardiovascular disease or diabetes. Those are conditions, the investigators noted, in which treatment can prevent serious consequences that can require extra doctor visits, hospitalizations and expense. When such previously uninsured people became eligible for Medicare, they had 13% more doctor visits, 20% more hospitalizations, and reported 51% greater medical expenditures than those with the same diseases who had had insurance all along.
The study also shows that it may be less expensive than expected to provide universal health insurance. Medicare is bearing the brunt when uninsured people put off seeing doctors or seeking medical care until they turn 65. The uninsured were very different from the insured people in the study. They had much less education, their incomes were lower, they were more likely to smoke and to be depressed.
