“Lack of insurance coverage, high costs, and poor outcomes are well-documented problems in the U.S. health care system, and policies to address them have been hotly debated for decades. However, complexity is another underappreciated problem that hinders access and affordability and is more difficult to quantify,” Larry Levitt and Drew Altman of the Kaiser Family Foundation write over at JAMA Health Forum. “A recent survey by K.F.F., with support from the Robert Wood Johnson Foundation, provides some hints at the scope of the problem for U.S. consumers with various types of health coverage. Findings from interviews with a nationally representative sample of 3605 privately and publicly insured adults reveal that many are perplexed with their health care plans. Almost 6 in 10 people with insurance reported a problem with using their health insurance during the past year. The share increases to two-thirds for people in fair or poor health, three-fourths for those who need mental health services, and almost 8 in 10 for people who use the health system the most. The result is that many delay or skip care or accumulate bills they cannot afford. Problems vary somewhat by type of coverage … but at least half of those with any of the 4 major types of health insurance (employer-provided, Medicare, Medicaid, or from the Affordable Care Act [A.C.A.] marketplace) said they had a problem using their coverage during the past year. The issues ranged from the most basic, such as not getting an appointment with a physician covered by their plan, to discovering that their medications are not covered or being denied prior authorization for care recommended by their physician. Of those who reported insurance problems, 15% said their health declined as a result. More than one-quarter of those who reported problems say they had to pay more for their care.” Larry Levitt and Drew Altman, “Complexity in the US Health Care System Is the Enemy of Access and Affordability,” JAMA Health Forum.
