Many of those without, or with inadequate, health insurance, face early disability or death.
Chronic illness plagues uninsured
Findings undermine the idea that those without coverage are healthy.
By Reed Abelson
New York Times
Posted: Tuesday, Aug. 05, 2008
Millions of Americans with chronic diseases, such as diabetes or high blood pressure, are not getting adequate treatment because they are among the nation's growing ranks of uninsured.
That is the central finding of a new study to be published today in the medical journal Annals of Internal Medicine.
The study, the first detailed look at the health of the uninsured, estimates that about one of every three working-age adults without insurance in the United States has received a diagnosis of a chronic illness. Many of these people are forgoing doctors' visits or relying on emergency rooms for their medical care, the study said.
The report, based on an analysis of government health surveys of adults ages 18 to 64 years old, estimated that about 11 million of the 36 million people without insurance in 2004 - the latest year of the study - had received a chronic-condition diagnosis.
"These are people who, with modern therapies, can be kept out of trouble," said Dr. Andrew Wilper, the study's lead author. Therapies for someone with diabetes and hypertension "are routine and widely available, if you have insurance," said Wilper, a medical instructor at the University of Washington in Seattle.
The most recent government estimate of the number of people in this country without health insurance is 47 million, which means that if the proportions found in the study have remained constant, there might be nearly 16 million with a chronic condition but no insurance to pay for medical care.
Nearly a quarter of the uninsured with a chronic illness who were surveyed said they had not visited a health professional within the last year. About 7 percent said they typically went to a hospital emergency room for care.
"A lot of people are suffering from a lack of health insurance," said Dr. Steffie Woolhandler, another of the study's authors, who is a physician and associate professor of medicine at Harvard.
People with high blood pressure, for example, are at risk for catastrophic medical events like a stroke if they are not getting the drugs they need or having a doctor monitor their disease, said Karen Davis, president of the Commonwealth Fund. The fund, a foundation in New York that specializes in health care research, has done its own research into the lack of adequate medical care among the uninsured.
The study may have underestimated exactly how many people who are uninsured have a chronic illness, because it includes only those who have already received such a diagnosis, the authors said. Individuals who have not had their conditions diagnosed because they are not seeing a doctor or nurse are not included.
The study's authors say that their findings cast doubt on the common assumption that many of the uninsured tend to be young and healthy, requiring little in the way of medical care. Because so many actually have chronic conditions that may be expensive to treat, the cost of covering the uninsured is often underestimated, said Woolhandler, who advocates a nationalized system of health care.
In Massachusetts, she said, the state's effort to overhaul its health insurance system to cover more residents is costing much more than expected and has not led to universal coverage because policy makers assumed that more people would be healthy.
"The state experiments have all failed because of cost," Woolhandler said.
The study describes harsh consequences for neglecting easily treatable diseases in so many people.
"For some of the 11.4 million uninsured Americans with serious chronic conditions, access to care seems to be unobtainable; many may face early disability and death as a result," the study's authors said.
advocate quoted :
Quote:The study's authors say that their findings cast doubt on the common assumption that many of the uninsured tend to be young and healthy, requiring little in the way of medical care. Because so many actually have chronic conditions that may be expensive to treat, the cost of covering the uninsured is often underestimated, said Woolhandler, who advocates a nationalized system of health care.
In Massachusetts, she said, the state's effort to overhaul its health insurance system to cover more residents is costing much more than expected and has not led to universal coverage because policy makers assumed that more people would be healthy.
"The state experiments have all failed because of cost," Woolhandler said.
The study describes harsh consequences for neglecting easily treatable diseases in so many people.
"For some of the 11.4 million uninsured Americans with serious chronic conditions, access to care seems to be unobtainable; many may face early disability and death as a result," the study's authors said.
reading : "The state experiments have all failed because of cost" makes it sound as if an experiment had been conducted on rats or mice .
OOOPS ! if the study had been conducted on rats or mice the SPCA would probably have stepped in to ensure the welfare of the animals - but since it only involves people ... there is probably little need to be concerned .
hbg
Those who died gave their lives to rugged USA capitalism, and should be congratulated.
advocate wrote :
Quote:Those who died gave their lives to rugged USA capitalism, and should be congratulated.
will they be asked to stand up to be recogniced ?
hbg
I guess they went proudly to their graves.
BTW, those in government and in high-up private positions have great health plans. The peasants should be glad for them.
Advocate, The word is "envious." We're still stuck in that place where the righties don't mind spending 2.7 billion every week in Iraq, but woe be to us if that money was spent on our own people. The Iraqis are much more important.
cicerone imposter wrote:Advocate, The word is "envious." We're still stuck in that place where the righties don't mind spending 2.7 billion every week in Iraq, but woe be to us if that money was spent on our own people. The Iraqis are much more important.
Right you are! What is so amazing is that so few of the electorate manage to see this. I guess they revel in their ignorance.
Advocate wrote:cicerone imposter wrote:Advocate, The word is "envious." We're still stuck in that place where the righties don't mind spending 2.7 billion every week in Iraq, but woe be to us if that money was spent on our own people. The Iraqis are much more important.
Right you are! What is so amazing is that so few of the electorate manage to see this. I guess they revel in their ignorance.
Politics and religion does funny things to people's mind.
That's true c.i.
Bit of a novelty eh?
Sould the state help the ailing people?
are we humans to allow this nonsense?
Don't you think that your high life will come to an end?
USAFHokie80 wrote:... GWB rode gay marriage into the white house.... obviously people do care.
that's really beside the point though. just because people want something, doesn't mean it is in their best interest. children would eat candy and drink soda all day. they would not go to school if they could. is that good for them ?
seriously, i wish there were a way to change the system. the opinion of a million idiots should not overshadow the opinion of a few scholars.
Dictatorships do it your way, the opinion of the few over the opinion of the many.
The easiest solution is for you to move somewhere with a nice dictatorship.
Perhaps Dr Castro would welcome you. He is quite the scholar.
Or Iran. The ruling despot is a college professor.
Advocate wrote:Many of those without, or with inadequate, health insurance, face early disability or death.
Chronic illness plagues uninsured
Findings undermine the idea that those without coverage are healthy.
By Reed Abelson
New York Times
Posted: Tuesday, Aug. 05, 2008
Millions of Americans with chronic diseases, such as diabetes or high blood pressure, are not getting adequate treatment because they are among the nation's growing ranks of uninsured.
That is the central finding of a new study to be published today in the medical journal Annals of Internal Medicine.
The study, the first detailed look at the health of the uninsured, estimates that about one of every three working-age adults without insurance in the United States has received a diagnosis of a chronic illness. Many of these people are forgoing doctors' visits or relying on emergency rooms for their medical care, the study said.
The report, based on an analysis of government health surveys of adults ages 18 to 64 years old, estimated that about 11 million of the 36 million people without insurance in 2004 - the latest year of the study - had received a chronic-condition diagnosis.
"These are people who, with modern therapies, can be kept out of trouble," said Dr. Andrew Wilper, the study's lead author. Therapies for someone with diabetes and hypertension "are routine and widely available, if you have insurance," said Wilper, a medical instructor at the University of Washington in Seattle.
The most recent government estimate of the number of people in this country without health insurance is 47 million, which means that if the proportions found in the study have remained constant, there might be nearly 16 million with a chronic condition but no insurance to pay for medical care.
Nearly a quarter of the uninsured with a chronic illness who were surveyed said they had not visited a health professional within the last year. About 7 percent said they typically went to a hospital emergency room for care.
"A lot of people are suffering from a lack of health insurance," said Dr. Steffie Woolhandler, another of the study's authors, who is a physician and associate professor of medicine at Harvard.
People with high blood pressure, for example, are at risk for catastrophic medical events like a stroke if they are not getting the drugs they need or having a doctor monitor their disease, said Karen Davis, president of the Commonwealth Fund. The fund, a foundation in New York that specializes in health care research, has done its own research into the lack of adequate medical care among the uninsured.
The study may have underestimated exactly how many people who are uninsured have a chronic illness, because it includes only those who have already received such a diagnosis, the authors said. Individuals who have not had their conditions diagnosed because they are not seeing a doctor or nurse are not included.
The study's authors say that their findings cast doubt on the common assumption that many of the uninsured tend to be young and healthy, requiring little in the way of medical care. Because so many actually have chronic conditions that may be expensive to treat, the cost of covering the uninsured is often underestimated, said Woolhandler, who advocates a nationalized system of health care.
In Massachusetts, she said, the state's effort to overhaul its health insurance system to cover more residents is costing much more than expected and has not led to universal coverage because policy makers assumed that more people would be healthy.
"The state experiments have all failed because of cost," Woolhandler said.
The study describes harsh consequences for neglecting easily treatable diseases in so many people.
"For some of the 11.4 million uninsured Americans with serious chronic conditions, access to care seems to be unobtainable; many may face early disability and death as a result," the study's authors said.
Yet another self-serving "analysis" from the self appointed spokesmen of the medical establishment. The key, but unanalyzed issue here is cost and who will pay it. The fact is that in countries with "universal" health care systems managed by the government, the rationing of health care services is performed by government bureaucrats and the legislators who appropriate the budgets. Because no one is actually responsible for the difficult tradeoffs of supply, cost and demand, the rules are made by bureaucrats who end up paralyzing the system of care itself. Universal mediocracy is the usual result. Those "suffering" from high blood pressure - an ailment almost always the exclusive result of poor lifestyle choices - have no incentive to change their bad habits - the medical providers are guaranteed inexaustable demand for their services; the lovers of bureaucracy get to manage other people's lives; and individual people lose their freedom of choice and responsibility for their own lives. Some deal !!
georgeob1 wrote: Those "suffering" from high blood pressure - an ailment almost always the exclusive result of poor lifestyle choices - have no incentive to change their bad habits - the medical providers are guaranteed inexaustable demand for their services; the lovers of bureaucracy get to manage other people's lives; and individual people lose their freedom of choice and responsibility for their own lives. Some deal !!
As you know, George, I don't live in a country with a general health care run by the government but by insurance companies.
Hypertension is indeed, however, an illness, which leads to many, much too many death here.
Certainly, a change in life style (like exercises, diet etc) helps a lot.
That's why insurance companies pay for such courses - it's cheaper than paying the hospital stay and the four weeks in a rehabilitation hospital after a stroke.
My mother was a sport teacher, lived in diet (well kind of) all her life, ... and did gymnastics until she was 92 and got the stroke: she had had hypertension all the last 30, 40 years, and, yes, she and we were glad that she "lost her freedom of choice and responsility for her own life" but got the medicaments (and courses and hospital stay and rehab) from her insurance company.
We'll get soon vaccinations as well (CYT006-AngQb). I would be pleased if this helps a lot more people from dying.
Even if it's more buraucracy.
How about if the government let them keep more of their own money, so they could get vaccinations sooner, instead of waiting for the government to pass a law to get it done?
Now there's an idea.
Well, vaccinations must be approved here before allowed being used.
Which isn't a bad think, in my opinion and those of others as well as doctors, pharmacists etc here.
And as far as I found out, you even can't get that vaccination in the USA.
Vaccinations [at least most, but all the important] are included in our mandatory general health insurance - we don't have to pay for such here.
But there's one country in the developed world without general health insurance ...
george wrote :
Quote:Yet another self-serving "analysis" from the self appointed spokesmen of the medical establishment. The key, but unanalyzed issue here is cost and who will pay it. The fact is that in countries with "universal" health care systems managed by the government, the rationing of health care services is performed by government bureaucrats and the legislators who appropriate the budgets. Because no one is actually responsible for the difficult tradeoffs of supply, cost and demand, the rules are made by bureaucrats who end up paralyzing the system of care itself. Universal mediocracy is the usual result.
Those "suffering" from high blood pressure - an ailment almost always the exclusive result of poor lifestyle choices
(my emphasis - hbg)
- have no incentive to change their bad habits - the medical providers are guaranteed inexaustable demand for their services; the lovers of bureaucracy get to manage other people's lives; and individual people lose their freedom of choice and responsibility for their own lives. Some deal !!
here is what the
U.S. NATIONAL INSTITUTE OF HEALTH has to say about HYPERTENSION :
Quote:CAUSES
Blood pressure measurements are the result of the force of the blood produced by the heart and the size and condition of the arteries.
Many factors can affect blood pressure, including how much water and salt you have in your body, the condition of your kidneys, nervous system, or blood vessels, and the levels of different body hormones.
High blood pressure can affect all types of people. You have a higher risk of high blood pressure if you have a family history of the disease. High blood pressure is more common in African Americans than Caucasians.
Most of the time, no cause is identified. This is called essential hypertension.
High blood pressure that results from a specific condition, habit, or medication is called secondary hypertension.
Too much salt in your diet can lead to high blood pressure. Secondary hypertension may also be due to:
Adrenal gland tumor
Alcohol poisoning
Anxiety and stress
Appetite suppressants
Arteriosclerosis
Birth control pills
Certain cold medicines
Coarctation of the aorta
Cocaine use
Cushing syndrome
Diabetes
Kidney disease, including:
Glomerulonephritis (inflammation of kidneys)
Kidney failure
Renal artery stenosis
Renal vascular obstruction or narrowing
Migraine medicines
Hemolytic-uremic syndrome
Henoch-Schonlein purpura
Obesity
Pain
Periarteritis nodosa
Pregnancy (called gestational hypertension)
Radiation enteritis
Renal artery stenosis
Retroperitoneal fibrosis
Wilms' tumor
i don't belive i need to add any comments .
hbg
As with most things human, including health issues, it's based on genes and environment; not strictly lifestyle - although it can help. Not smoking and getting regular exercise are two important personal choices.
Walter Hinteler wrote:Well, vaccinations must be approved here before allowed being used.
Which isn't a bad think, in my opinion and those of others as well as doctors, pharmacists etc here.
And as far as I found out, you even can't get that vaccination in the USA.
Vaccinations [at least most, but all the important] are included in our mandatory general health insurance - we don't have to pay for such here.
But there's one country in the developed world without general health insurance ...
Yeah, it's a thing called freedom. Some people make bad choices, some people make good choices.
But forcing people to do all the things they SHOULD do, like eating the right things, buying health insurance, getting sufficient exercise, not smoking, etc is not the way we've chosen as a nation.
Freedom is quite a unique concept, and not generally used even in many countries in the developed world.
c.i. wrote :
Quote:As with most things human, including health issues, it's based on genes and environment; not strictly lifestyle - although it can help. Not smoking and getting regular exercise are two important personal choices.
but as the U.S. NATIONAL INSTITUTE OF HEALTH states :
Quote:Most of the time, no cause is identified. This is called essential hypertension.
i wonder if those with "essential hypertension" - apparently "most of the time" - will see any true benefit from exercising to get their BLOOD PRESSURE under control .
i'm reasonably sure that moderate exercise is generally a good thing - but will it get essential hypertension under control ?
hbg
hbg, Just because the medical field hasn't identified the cause of essential hypertension, that doesn't mean the patient should ignore the benefits of not smoking and exercise. The benefits outweighs any mystery of the disease and its cause.
