Most Americans are beneficiaries of healthcare coverage in multiple ways which include private insurance coverage arranged by their employers, coverage purchased on their own and public insurance programs such as Medicare and Medicaid. It is believed that about 160 million Americans enjoy employer-sponsored health insurance, and another 13 million have bought insurance directly from an insurer or HMO.
Total spending for health care services continues to steeply rise - from $1.4 trillion in 2001 to an estimated figure of $3.1 trillion in 2012.
Insurance premium for people with private insurance have risen drastically in recent years. At the same time, consumers are also suffering because their out-of-pocket costs for deductibles and other cost sharing have gone up significantly over the same period.
While coverage availability has somewhat declined for those having employer coverage, a lackluster economy and high unemployment rate have intensified problems faced by those seeking individual coverage. The economists have to find ways to control increases in health care costs and to provide coverage for the uninsured.
Paying contributions, however small, towards health insurance policies discourage workers from joining the insurance scheme. Statistics reveal that about 20 percent of all uninsured people live in families where a worker has declined employer-sponsored insurance coverage. The refusal to avail employer-sponsored insurance is mostly because of the cost involved. For many, the health insurance is less of a priority compared to food and housing.
It must also be stated that the costs of private health insurance have risen steeply particularly in relation to a workers average earnings and general inflation. In the past three years, insurance premiums have increased between 10.9 and 13.9 percent annually, while workers' wages have grown only between 2 & 3 percent.
The cost of health care is certainly burdensome for most Americans but it those with limited means are hit the hardest. Nearly 75% of low-income group adults reported some difficulty obtaining health coverage.
Consequently, 44 percent of low-income group adults remain uninsured at compared with only 13 percent of moderate- and higher-income adults in the non-insured category. Despite the fact that the United States is spending nearly $200 billion every year on tax incentives for health insurance, 46.6 million people still lack health coverage.
The one redeeming news is children-especially those in low-income families have somewhat gained in insurance coverage. Even with regard to uninsured children, more than 50% of them are eligible for Medicaid or the State Children's Health Insurance Program (SCHIP)-the two public insurance programs responsible for providing coverage to low-income group children.
Established in 1997, the State Children's Health Insurance Program provides states the authority and funding to expand health insurance coverage to low-income children by broadening Medicaid eligibility, developing new child health programs, or a combination of both.
While Medicaid and the State Children's Health Insurance Program has effectively covered low-income group children, the same cannot be said for children in middle-income group families, for whom access to Medicaid and SCHIP is not easily accessible. Yet the unfortunate fact remains that racial and ethnic disparities in children's health insurance coverage persist, despite all gains.
As public coverage is generally not available to adults, almost 50% of the increase in uninsured adults belong to the low-incomes group leaving their families at great risk for being uninsured.