With apologies to John Donne: Send not to know for whom the bell (of inadequate health coverage) tolls. It tolls for thee. Even if thou hast health insurance. A study in this month's Health Affairs journal found that 25 million people ages 19 to 64 were underinsured in 2007, up from 16 million in 2003.
The study's authors define "underinsured" as those families earning more than $40,000 who carry health insurance but still spend 10% or more of their income on out-of-pocket medical expenses (or 5% of their income if they make less than $40,000). Nearly 50 million additional people have no health insurance at all. In all, "You end up with about 75 million adults who were either underinsured or uninsured at some time during the year," says study co-author Sara Collins, an assistant vice president of the Commonwealth Fund, a foundation that supports independent healthcare research.
Those who had inadequate insurance coverage were almost as likely as those with no insurance to avoid getting needed care or to suffer medically related financial problems. Some 53% of the underinsured went without needed care, compared with 68% of the uninsured. And 45% of underinsured people had trouble paying medical bills, compared with 51% of uninsured people. "You can have health insurance and still go bankrupt if you get sick," the authors note.