All the hoopla of graduation celebrations is over, and as young adults who’ve just graduated from high school or college face the end of summer holidays and the prospect of “the rest of their lives” a huge, gaping hole of medical coverage looms over most.
Largest sector without Health Protection
Ages 18 or 19 is a cut-off point from parents’ health insurance coverage for 60 percent of private and public health insurers in the U.S. That is usually extended to age 23 if they’re in college full-time. Then after college graduation they’re on their own. It doesn’t take any time at all for young people to experience the frustrations of choosing insurance, understanding what coverage they’re actually getting, then tracking payments, etc., etc.
The majority aren’t even trying for numerous reasons. Nearly 14 million Americans ages 19-29 were without health coverage in 2004, up 2.6 million since 2000. They are 17% of the population under 65yo but 30% of the uninsured population. Part of the reason may be that they’re young and healthy and therefore under the delusion that they’re invisible. Realtiy eventually sets in: 57% reported in a study by the Commonwealth Fund that they’re going without needed health care because of costs, such as not filling prescriptions, seeing a specialist or skipping treatments or labs. Medical debt has already hit 46% of the population.
Frustrations of dealing with Insurers
In choosing a health insurance policy the cost choices are, basically, lower monthly payment with higher deductible or higher monthly payment with lower deductible. If you have no serious health problems (if you do that’s a whole other problem) a lower monthly/higher deductible seems logical, but in the world of US health insurance nothing is ever so simple. Policies are never written in clear, plain language so that the consumer can understand (or anybody except the attorneys who drafted them). Physicians and dentists offices will readily claim, “Oh, yes, we take that insurance”, but after services are provided the consumer/patient learns that, oops, the insurance company only pays a reduced amount to this provider, and you’re liable for the remainder. And the doctor’s office often is unable to determine in advance how they will be paid. Then there’s the insurers who bill multiple times for the same visit/service, and it’s up to the consumer to track what they’ve paid or not.
Shortcomings at the Physicians Offices
In addition to not knowing costs in advance, physicians are usually oblivious to the costs of lab tests and prescribed drugs for the patient/consumer. And, yes, all labs and other tests are billed separately and paid off another scale you’ve never seen. Often x-rays and lab tests are conducted primarily in defense of the MD’s liability when their actual usefulness is marginal, and most of us don’t ask enough questions of the doctor to make any decisions ourselves (and young people certainly don’t ask questions). And MDs offices often can’t recommend a generic drug substitute for a prescription, which could save the young consumer (and all of us) considerable costs.
Graduates, welcome to the world we adults now cope with! My new graduate is moving to France (temporarily) which has the world’s best health care–she’s going to study French language, but universal health coverage is a great safety net. Bon voyage!
Salud!
Beverly A. Jensen, Ph.D.
President, www.WomensMedicineBowl.com
