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Lack Of Insurance Means Worse Care For Uninsured

40,000 were uninsured for at least part of the past year, up from 28 percent in 2001.

This study, which appears in the May 3 issue of the Journal of the American Medical Association, Ross and his team analysed data on almost 200,000 men and women aged 18 to 64 polled in 2002 on their medical history, health behaviours and use of health-care services. The incomes were divided into six categories: below $15,000, $15,000 to $25,000 to $35,000, $35,000 to $50,000, $50,000 to $75,000 and greater than $75,000.

They found that the use of different healthcare services varied tremendously. For instance, use of cancer-prevention services ranged from 51 percent for colorectal cancer screening to 88 percent for cervical cancer screening. Use of cardiovascular risk reduction services ranged from 38 percent for weight-loss counselling to 81 percent for aspirin use. Diabetes management services ranged from 33 percent for the pneumococcal vaccine to 88 percent for haemoglobin measurement. They noted that the gap between uninsured and insured was roughly the same regardless of the income category. Stating that for none of the groups did income affect use, Dr Ross said that all of their results were consistent across income.

Although the researchers were not looking for reasons specifically for the phenomenon, Dr Ross pointed to a number of possible explanations. He said that one factor they were most concerned about was that people simply don't believe that these services are sufficiently beneficial, or at least outweigh the costs.

Rukavina said that they people seem to be afraid of what they might find. He felt it like the fear of opening the Pandora's box. This is a problem both at that point in time when they discover there may be a problem that they have no insurance for and future costs, if their insurance will not cover it because it'd been identified, he said. The major question he felt is who should assume more of the costs.
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