Schoen Cathy, Collins Sara R, Kriss Jennifer L, Doty Michelle M
Commonwealth Fund in New York City, USA.
Health Aff (Millwood). 2008 Jul-Aug;27(4):w298-309. doi: 10.1377/hlthaff.27.4.w298. Epub 2008 Jun 10.
With health insurance moving toward greater patient cost sharing, this study finds a sharp increase in the number of underinsured people. Based on indicators of cost exposure relative to income, as of 2007 an estimated twenty-five million insured people ages 19-64 were underinsured-a 60 percent increase since 2003. The rate of increase was steepest among those with incomes above 200 percent of poverty, where underinsurance rates nearly tripled. In total, 42 percent of U.S. adults were underinsured or uninsured. The underinsured report high levels of access problems and financial stress. The findings underscore the need for policy attention to benefit design, to assure care and affordability.
随着医疗保险朝着让患者承担更多费用的方向发展，本研究发现未得到充分保险的人数急剧增加。根据相对于收入的费用负担指标，截至2007年，估计有2500万年龄在19至64岁之间的参保人员未得到充分保险——自2003年以来增加了60%。在收入高于贫困线200%的人群中，未得到充分保险的比例增长最为迅猛，几乎增至原来的三倍。总体而言，42%的美国成年人未得到充分保险或未参保。未得到充分保险的人群反映出存在大量就医困难和经济压力问题。这些研究结果凸显了政策层面关注福利设计以确保医疗服务可及性和可负担性的必要性。
