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Gaps Found in All Components of Private Health Insurance Coverage for People With Diabetes
Gaps Found in All Components of Private Health Insurance Coverage for People With Diabetes -- Posted by Gumbo on 02-16-05 05:29
Gaps Found in All Components of Private Health Insurance Coverage for People
With Diabetes
WASHINGTON, Feb 08, 2005 /PRNewswire via COMTEX/ -- The American Diabetes
Association in conjunction with the Georgetown University Health Policy
Institute today announced the results of a 14-month study examining barriers
to accessible, affordable and adequate health insurance for Americans with
diabetes. Entitled "Falling Through the Cracks: Stories of How Health
Insurance can Fail People with Diabetes," and funded by the Commonwealth
Fund, Robert Wood Johnson Foundation and W.K. Kellogg Foundation, the study
of 851 people from across the United States identifies barriers in all
components of the private health insurance system that can prevent Americans
with diabetes from properly managing the disease.
Common problems highlighted by the report document serious flaws in the
private and publicly financed health insurance system in America. These
flaws include health insurance policies that did not cover basic diabetes
needs; high risk pools with pre-existing condition exclusions that deterred
people from enrolling; health insurance premium surcharges for diabetes that
drove premiums above what individuals and small businesses could afford;
medical underwriting practices that designated diabetes as "uninsurable;"
Medicaid eligibility limits that left many low income people unable to
access this safety net; cumbersome insurance processes that fail to help
people navigate complex rules and deadlines; and application procedures that
drove many to give up on seeking coverage altogether.
For example, the study documents the story of Janice Ramsey, of Deltona,
Florida, who presented at the report's release. Mrs. Ramsey was a small
business owner who was dropped by her individual policy once she was
diagnosed with diabetes, left with $22,000 in debt by a fraudulent
association health plan, and turned down by numerous other carriers. At age
60, she remains uninsured and worries she and her husband could lose
everything if she gets seriously ill before she becomes eligible for
Medicare.
"This study observed many instances in which having diabetes can make it
harder to get and keep health insurance -- a profound irony given the
purpose of health insurance is to protect people when they are sick," said
Karen Pollitz, MPP, Project Director, Georgetown University Health Policy
Institute. "People in transition following a job loss or change in family
status often could not obtain new health coverage. Safety net options
created to help in these circumstances often didn't work because the help
they offer is incomplete. People with stable coverage also had problems when
they were underinsured, lacking coverage for blood glucose test strips and
prescriptions or burdened by high deductibles. The people we talked to
needed coverage that was available, affordable and adequate. Two out of
three just didn't work. Many people had trouble managing their diabetes, got
sicker or went into debt as a result. The implications of these coverage
problems for public health, costs to Medicare and Medicaid and the impact on
the entire health system due to uncontrolled diabetes are enormous."
R. Stewart Perry, Chair, Advocacy Committee of the American Diabetes
Association added, "This report shows that if you have diabetes in America,
you are at serious risk every day of losing your ability to manage the
disease due to a patchwork healthcare system that just doesn't fit together.
And, most of the policy solutions currently being considered by our state
and federal policy makers do little to fix the problems identified by the
report. Given that as many as one in 10 Americans live with diabetes today
in certain states and one in three Americans will have the disease by 2050,
it is time for policymakers to seriously rethink the flawed health insurance
solutions up for debate that harm as opposed to benefit people with
diabetes."
The study adds to what are troubling trends related to diabetes in America.
Already classified as an epidemic by the Centers for Disease Control and
Prevention, diabetes continues to impact more and more families in America
and it is growing 8% per year. Today, 6.3% of Americans live with the
disease but by the year 2050 one in three will have the disease but as many
as one in two minorities will live with diabetes. In 2002, one in ten
healthcare dollars and one in four Medicare dollars went towards diabetes
care. The cost of diabetes in America in 2002 was at least $132 billion. We
can reverse these trends, but to do so, we need a health care system that
allows diabetes patients to manage their care and that provides the tools to
help reduce the number of Americans who will be diagnosed with the disease.
To obtain copies of "Falling Through the Cracks: Stories of How Health
Insurance can Fail People with Diabetes," visit the American Diabetes
Association on the Internet at http://www.diabetes.org/insurancereport or
the Georgetown University Health Policy Institute at
http://www.healthinsuranceinfo.net.
Additionally, a webcast of this event will be webcast by kaisernetwork.org,
a free service of the Kaiser Family Foundation and available after 5:00 p.m.
ET, February 8, 2005, at
www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1357
Along with the webcast, a transcript will also be available.
About the American Diabetes Association
The American Diabetes Association is the nation's leading voluntary health
organization supporting diabetes research, information and advocacy. Our
advocacy efforts include helping to combat discrimination against people
with diabetes; advocating for the increase of federal diabetes research and
programs; and improved access to, and quality of, healthcare for people with
diabetes. The Association's mission is to prevent and cure diabetes and to
improve the lives of all people affected by diabetes. Founded in 1940, the
Association provides service to hundreds of communities across the country.
For more information please call the American Diabetes Association at
1-800-DIABETES (1-800-342-2383) or visit http://www.diabetes.org.
Information from both these sources is available in English and Spanish.
About Georgetown University's Health Policy Institute
The Health Policy Institute is a multi-disciplinary group of faculty and
staff dedicated to conducting research on key issues in health policy and
health services research. Institute members are engaged in a wide diversity
of projects, focusing on issues relating to health care financing, the
uninsured, federal health insurance reforms, quality of care and outcomes
research, mental health services research, and the impact of changes in the
health care market on providers and patients.
SOURCE American Diabetes Association
Copyright (C) 2005 PR Newswire. All Rights Reserved.
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