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U.S. Healthcare in a Glance

CNA / IHSP, 2/14/12

•    The percentage of adults with no health insurance is the highest on record, 17.3 percent of adults as of the third quarter of 2011. Three years ago, in the third quarter of 2008, only 14.4 percent of adults lacked health insurance. (Gallup, Politico, Nov. 11, 2011). By January, 2012, the percentage of unemployed was up to 17.7 percent.
(http://fdlaction.firedoglake.com/2012/01/24/number-of-uninsured-americans-steadily-increasing/)

•    Factoring out those 65 and over, eligible for Medicare, and young adults up to 26, now eligible to remain on their parent’s coverage as a result of the Affordable Care Act, the numbers are even higher. 19.9 percent of 26-64 year olds are uninsured, up from 18.1 percent in mid-2010.Further, the number getting health coverage from their employer continues to fall, now down to 44.5 percent in the third quarter of 2011 (Gallup, Politico, Nov. 11, 2011).

•    Total number of uninsured Americans- 49.9 million in 2010, up from 49 million in 2009 (U.S. Census Bureau, CNN/Money, Sept. 13, 2011). An additional 29 million Americans were underinsured in 2009, up from 16 million in 2003, an increase of 80 percent (Health Affairs, September, 2011)  

•    About half of unemployed and underemployed U.S. residents do not have health insurance and 56% are delaying necessary care because of concerns about cost.  Among those who said that they or another family member have delayed medical care because they could not afford it: 63% skipped dental care or checkups;  46% skipped a recommended test of treatment; 40% did not fill a prescription; and 18% reported problems receiving mental health services. (NPR/Kaiser Family Foundation survey, Dec. 12, 2011)

•    Between 2003 and 2010, premiums for employer-sponsored health insurance increased by a nationwide average of 50%.--  62 percent of Americans now live in a state in which health insurance premiums equal 20 percent or more of median earnings for adults younger than 65. In 2003, 13 states had annual premiums that comprised less than 14 percent of the median income. In 2010, there were none. Average annual premiums for family coverage were $13,871, with the average annual employee share at $3,721 in 2010, up from $2,283 in 2003. (Commonwealth Fund, Washington Post, Nov. 16, 2011; San Francisco Chronicle, Nov. 17, 2011)

•    Under a study of high income countries, sicker adults in the U.S. stood out for having cost and access problems. More than one of four (27%) were unable to pay or encountered serious problems paying medical bills in the past year, compared with between 1 percent and 14 percent of adults in the other countries. In the U.S., 42 percent reported not visiting a doctor, not filling a prescription, or not getting recommended care. This is twice the rate for every other country but Australia, New Zealand, and Germany. (Commonwealth Fund, Nov. 9, 2011)

•    On life expectancy, between 2000 and 2007, more than 80% of U.S. counties fell in standing against the average of the 10 nations with the best life expectancies in the world. Some US counties are more than 50 calendar years behind – meaning they have a life expectancy today that nations with the best health outcomes had in 1957. Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind Honduras, El Salvador, and Peru. Four of those counties have the lowest life expectancies for men, all below 67 years, behind Brazil, Latvia, and the Philippines. Nationwide, women fare more poorly than men. Women in 1,373 counties – about 40% of US counties – fell more than five years behind the nations with the best life expectancies. Men in about half as many counties – 661 total – fell that far.  Black men and women have lower life expectancies than white men and women in all counties. (Institute for Health Metrics and Evaluation (IHME) at the University of Washington, June 15, 2011)

•    In a global survey of inequality in healthcare for children, the US ranked just 22nd in material well being for children, behind even economically struggling Greece. (Unicef study, December, 2010)

•    Between 2003 and 2007, the average maternal mortality rate – defined by deaths that occur within 42 days of childbirth – rose to 13 deaths per 100,000 live births, approximately double the low of 6.6 deaths per 100,000 live births recorded in 1987. Today, the United States ranks 41st in the world for maternal mortality, one of the worst records among developed countries. "Near misses", complications so severe that a woman nearly dies, increased between 1998 and 2005 to become common – at one woman every 15 minutes. African American women are three to four times more likely to die of pregnancy-related death than white women. States in which poverty rates exceeded 18% had a 77% higher rate of maternal mortality than states with lower rates of poverty. Over the last seven years, federal spending for maternal and child health programs has been reduced by 10%. (Guardian, UK, July 5, 2011)

•    More than one in four U.S. emergency departments were closed in the past two decades, forcing the nation’s poor and elderly to seek care in fewer, more crowded facilities. The number of emergency rooms in metropolitan and suburban areas fell 27 percent to 1,779 in 2009 from 2,446 in 1990. (Bloomberg News, May 17, 2011)

•    Illness and medical bills are linked to 62 percent of all U.S. personal bankruptcies. The proportion of bankruptcies attributed to medical bills rose by nearly 50 percent between 2001 and 2007 (Physicians for a National Health Program, 2009).

•    In California, the only state that makes such data public, the seven largest private insurers rejected 26% of claims in 2010. Typically, the rejections came from payment disputes between the insurers and providers, such as doctors and hospitals, but often that resulted in patients and families getting stuck with massive bills in a system that does little to control costs. Outright care denials are all too common from insurers, which have developed a laundry list of lingo to justify denial of care, such as transplants, even when recommended by the patient's physician.

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California Nurses Association/Institute for Health and Socio Economic Policy, Jan. 28, 2011

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