Study reports high medical debt rate

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More than two out of five working adults struggle with medical bills or carry medical debt, according to a report released yesterday.

Nearly 71 million working Americans, ages 19 to 64, reported having problems paying their medical expenses in 2003, said the study by the Commonwealth Fund, a New York health research organization.

An estimated 27.7 million working adults carried medical debt in 2003, the study said.

"We were surprised by the extent of the problem, especially among the insured," said Michelle Doty, author of the study and a senior analyst at the organization, which promotes increased health care access for Americans.

About 62 percent of the adults facing unpaid medical bills were insured at the time, the study said.

But one public-policy research group argued that the study did not give an accurate view of working Americans because it oversampled low-income blacks and Hispanics.

"Why are they oversampling in the first place?" asked Devon Herrick, a senior fellow at the National Center for Policy Analysis, a Dallas organization that promotes free enterprise.

"To me, this is just a survey of people who don't want to pay for health care and want someone else to pay for it. It's just another excuse to expand public coverage of health care," Mr. Herrick said.

Ms. Doty acknowledged that the study deliberately oversampled low-income workers. Researchers then balanced the study with data from the U.S. Census Bureau, she explained.

The new Commonwealth Fund study is a more detailed version of a March 2004 study that the group conducted on the rising cost of health care. The previous report, from which Ms. Doty based her study, surveyed 4,052 persons 19 and up from September 2003 to January 2004.

Ms. Doty countered that her study was an "absolutely representative sample" of working U.S. adults.

The findings are intended to highlight the growing problem of "underinsured" consumers, who have insurance but end up paying high out-of-pocket costs because their policies offer minimal coverage, she said.

An estimated 16 million adults were classified as "underinsured" in 2003, according to a June report by the Commonwealth Fund.

The new study cautioned policy-makers against overpromoting health care savings accounts, insurance that combines a high-deductible health plan with a savings account.

Ms. Doty noted that 49 percent of adults who had a yearly deductible of $500 or more reported problems paying medical bills. About 32 percent of participants with lower deductibles had the same difficulties, the report said.

But advocates for the health care savings accounts said these plans generally have more liberal coverage than regular health care plans, once consumers pay the deductible.

"Many of the high-deductible plans cover 100 percent of medical expenses after the deductible is met," said Grace-Marie Turner, president for the Galen Institute, an Alexandria market research organization that advocates consumer choice in health care.