Chronic conditions and medical debt grow, and some employers get targeted

Americans' problems paying medical bills are increasing, especially for those people managing chronic conditions.

In 2007, 3 in 10 people with chronic conditions were in families with problems paying medical bills, compared to 21% of people in 2003.

According to Financial and Health Burdens of Chronic Conditions Grow, a Tracking Report from The Center for Studying Health System Change (HSC) published in April 2009, there were 20 million chronically ill adults with medical bill problems in 2007 - and one in 4 of them went without a prescription because of cost.

HSC's report focuses on working-age adults, 65% of whom are covered with private insurance as shown in the chart. In 2007, 39% of this population (72 million people) had at least one chronic condition, an increase from 35% in 2001.

At the same time, employers who provide health coverage are eroding their health plans due to cost pressures and the current recessionary climate. In 2001, 71% of working-age people were covered by private plans; by 2007, 65% were.

HSC points out that both the uninsured and the insured are facing problems paying medical bills. Medical debt rose substantially between 2003 and 2007.

Health Populi's Hot Points: For those fortunate enough to have private health coverage in 2009, most employers say they're targeting specific chronic conditions to improve the health and productivity of workers.

In its annual survey of employers, Hewitt found that the percentage of companies directly targeting chronic conditions such as diabetes and heart disease increased by 30 percentage points between 2008 and 2009.

Hewitt calculated that for diabetes alone, an average large employer with 9,500 employees and 500 pre-65 retirees spends $18 to $22 million on direct medical care for its diabetic population.

For those people without health insurance, medical debt will continue to mount and access to needed health services with decline as a result of cost. HSC's numbers are based on their 2007 Tracking Survey. Expect the medical debt problem to exacerbate in 2009 and beyond until chronically ill Americans, covered and uninsured, have access to coordinated care.