Causes and Effects of Lack of Health Insurance

The most recent estimates on the lack of health insurance in the United States show that 46 million people, aged 65 and above, currently lack health insurance (Center for Disease Control and Prevention, 2011). In children, the highest uninsurance rates occur in minority group members, especially Hispanics and African-American children (Flores et al., 2016). Several reasons have been attributed to the rising uninsurance rates. They include high cost, loss of job, change of employment, refusal of the employer to cover some employees, denial by insurance companies to cover some individuals, and termination of Medicaid benefits (Center for Disease Control and Prevention, 2011). The lack of insurance has been found to have detrimental health effects on the uninsured, such as premature death, deferred treatment, inadequate screening for serious illnesses, higher risk of entering healthcare system in poorer health, less therapeutic care, and adverse medical outcomes.

First, because individuals without health insurance coverage have less access to routine preventive services like the insured population, they are at a higher risk of premature death. Specifically, the uninsured are more likely to die from acute and chronic conditions such as strokes. There are various ways in which health insurance reduces mortality. Some of these ways include the availability of care when needed, the presence of a regular source of medical care, and continuity of coverage. The uninsured population is also more likely to miss life-saving care than the insured ones.

Second, uninsured individuals are more likely to defer or fail to receive the required treatment. Specifically, they are less likely to get the much needed medical care in response to the onset of particular diseases or their symptoms, that require the medical attention of physicians. In most cases, the uninsured individuals avoid seeking medical treatment except when they have an emergency. They also tend to delay treatment until their symptoms become almost intolerable. Consequently, the uninsured are more likely to have delayed diagnosis and are more likely to suffer life-threatening complications as a result of worsened health conditions.

Third, the uninsured do not receive adequate screening for serious illnesses. Because effective treatment and management of diseases are highly dependent on early detection of the diseases, failure to undergo early screening increases morbidity and mortality rates. It is worth noting that early detection is essential for survival in patients with chronic and life-threatening illnesses such as cancer. Often, early diagnosis of diseases increases the chances of cure and their successful management. When a disease is treated early, problems associated with the disease can be delayed. In the case of chronic conditions, early treatment can make the condition easy to live with.

Fourth, uninsured individuals are at a higher risk of entering health care system in more adverse health or more advanced disease stage than the insured population. Because they face difficulties accessing needed care and are at a higher likelihood of foregoing screening services, it is projected that the uninsured will enter the health care system in poorer health than the insured individuals. In most cases, the uninsured are also admitted to hospitals with many diseases and conditions than the insured. Therefore, they are expected to have higher morbidity and mortality rates. For example, the uninsured cancer patients are often diagnosed at late stages when the disease has spread beyond the original site, thus reducing the chances of successful treatment. Similarly, uninsured persons receive late diagnosis and treatment for sexually transmitted infections, which can progress into severe health conditions and elevate the risk of contracting HIV. Moreover, uninsured individuals who are HIV-positive are more likely to miss treatment until the disease is at an advanced because of failure to know their status at early stages of infection.

Fifth, the uninsured obtain less therapeutic care, even if their diseases are at acute stages. Similarly, individuals with life-threatening conditions do not always receive adequate medical treatment, and their illnesses are also not monitored on a regular basis. As a result, their conditions are likely to get more aggravated.

Lastly, the uninsured population has reported poorer medical outcomes than the insured ones, especially after accidents or in chronic diseases. Uninsured individuals with acute, chronic conditions are at a higher risk of death while they are hospitalized and shortly after being discharged from the hospital. Moreover, uninsured patients who have undergone serious injuries following accidents have low chances of attaining full recovery and are more likely to die because of injuries or to report subsequent deteriorations in their health.

In conclusion, medical insurance is a key determinant of an individuals health outcomes. The absence of health insurance due to high cost, job loss, a change in employment status, employers refusal to offer insurance, insurers denial to cover some people, and termination of Medicaid benefits has been associated with adverse health consequences. These individuals are more likely to have premature deaths, delayed treatment, inadequate screening for severe conditions, elevated risk of entering healthcare system in poorer health, decreased therapeutic care, and poorer medical outcomes.

References

Center for Disease Control and Prevention (2011). QuickStats: Reasons for No Health Insurance Coverage* Among Uninsured Persons Aged <65 Years --- National Health Interview Survey (NHIS), United States, 2009. Cdc.gov. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a9.htm?s_cid=mm6001a9_w

Flores, G., Lin, H., Walker, C., Lee, M., Portillo, A., & Henry, M. et al. (2016). A cross-sectional study of parental awareness of and reasons for lack of health insurance among minority children, and the impact on health, access to care, and unmet needs. International Journal For Equity In Health, 15(1). http://dx.doi.org/10.1186/s12939-016-0331-y