Americans — both insured and uninsured people — are delaying health care due to cost and health-system challenges, according to the latest Tracking Report from the Center for Studying Health System Change (CSHSC).

Delaying care is particularly acute for people who are in poor or fair health, and those with low-income. Here’s another example of a gap between rich and poor Americans growing wider.

Overall, the Center calculates that in 2007, 20% of Americans reported not getting or delaying necessary care at some point in the previous year. But the Center points out that the gap between insured and uninsured people narrowed a bit. In 2003, the uninsured were 3.4x as likely to go without care, and 2.8x likely to forego care in 2007.

The driver among the insured population for delaying medical care is rising costs: including out of pocket deductibles, coinsurance, and copayments that disincent people from seeking health services. Note, too, one of the health system challenges that more insured people are facing in 2007 compared to 2003: 18.9% of people report that their health plan would not cover treatment in 2003; in 2007, 28.1% — nearly 50% more insured people — said their health plan wouldn’t cover a treatment.

Health Populi’s Hot Points: As we expect employers and plan sponsors to continue to increase costs on the insured enrolled population, we may well anticipate a trend in delaying health care, even when a consumer believes care is required. Cost concerns are intensifying among consumers. Further exacerbating the cost picture for families is high prices for consumer goods: notably energy and fuel costs, access to credit for loans of all types, and a recession of which “we are on the brink” according to Alan Greenspan, who told a conference in Johannesburg this week that an economic rebound in the U.S., “is not something I think is in the immediate outlook.”