25 Million Americans Are 'Underinsured'

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Kim Bailey, a senior policy analyst at Families USA, a health-care advocacy group, said she thinks the trend toward greater out-of-pocket costs for health care is likely to continue.

"It is clear that American families are facing a growing burden of out-of-pocket costs, and this is consistent with a decay in the comprehensiveness of health benefits being offered," she said.

Bailey noted that between 2000 and 2007, the average family premium for employer-sponsored insurance rose more than 90 percent. "We are getting to a place were a number of people are feeling the squeeze," she said. "This report highlights the thinning of benefits on higher income people and that is new. That indicates to me that a call for change is likely to be strengthened."

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Another expert said the new report probably underestimates the problem of underinsurance.

"There are a whole lot of ways to be underinsured that the report does not capture," said Dr. Steffie Woolhandler, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program.

The deductible is only a fraction of the total amount one has to pay out-of-pocket, Woolhandler said. "In addition to the deductible, there are issues such as co-insurance and the issue of uncovered services, which are not part of the deductible," she said.

Woolhandler also noted that many people lose their job and their health insurance when they become disabled. "At least 25 percent of employers terminate employment the day you become disabled," she said.

More information

For more on health insurance, visit The Commonwealth Fund.

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