Health care costs have been rising faster than the rest of the U.S. economy for many years. Out-of-pocket payments for health care services by patients increased from $162 billion in 1997 to $236 billion in 2004, according to background information in the article. Jessica S. Banthin, Ph.D., and Didem M. Bernard, Ph.D., of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services, Rockville, Md., examined the net impact of various trends in costs and coverage and changes in benefits on the percentage of family income devoted to insurance and medical care expenditures among the nonelderly population.

"We found that the prevalence of high financial burdens increased across the population as a whole and among several subgroups between 1996 and 2003," the authors write. By 2003, there were 48.8 million individuals (19.2 percent of the population) living in families that spent more than ten percent of family income on medical care, an increase of 11.7 million persons since 1996. Of these individuals, 18.7 million (7.3 percent of the population) lived in families spending more than 20 percent of family income on medical care in 2003.

In 2003, individuals with higher-than-average risk of incurring high total burdens included poor and low-income individuals and those with nongroup coverage, age 55 to 64 years, living in a non-metropolitan statistical area, in fair or poor health, having any type of limitation, or having a chronic medical condition.

"Our measure of health care service burden can be used to identify the underinsured, that is insured persons without adequate financial protection from high out-of-pocket costs. By this definition, we estimate that 17.1 million insured persons younger than 65 years were underinsured in 2003, including 9.3 million persons with private employment-related insurance, 1.3 million persons with private nongroup policies, and 6.6 million persons with public coverage," they write.

MEDICA.de; Source: American Medical Association