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Health Care Reform:

Health Insurance & Affordable Care Act

Report: Most People Either Can't Get It or Can't Afford It

WebMD Health News

Buying Health Insurance on Your Own

Dec. 3, 2007 -- Most people who try to buy health insurance on their own find that they either can't get it or can't afford it, even if they are relatively healthy, a yearlong investigation by Consumer Reports shows.

Of the roughly one in seven people surveyed who had no health insurance, 76% said they could not afford to buy it.

Only about 7% of those surveyed had purchased health insurance on their own, and 71% of these people were unhappy with their policies.

More than half cited high premium costs as a major reason for their dissatisfaction, and 45% said economic considerations had caused them to postpone needed medical care.

The report appears in the January issue of Consumer Reports, the publication of the nonprofit advocacy group Consumers Union.

"People who don't have access to employer-provided health insurance are at an extreme disadvantage," Consumer Reports Health Editor Nancy Metcalf tells WebMD. "We learned that private insurance is virtually out of the question for most uninsured Americans. This is a market that is completely dysfunctional from beginning to end."

The High Cost of Good Health

Cumming, Ga., real estate agent Maggie Frazier is all too familiar with the problem.

Diagnosed with rheumatoid arthritis in 1988, Frazier tells WebMD that she was virtually crippled by the disease until powerful drugs became available to treat it.

"I was to the point where I couldn't even comb my own hair," she says. "That is how aggressive my rheumatoid arthritis was."

She now takes injections of the immune-system suppressing drug Enbrel, at a cost of $1,400 to $1,700 a month.

Her employer-provided health insurance picks up most of the tab, but Frazier is about to lose this coverage because the plan is being terminated. Most private health insurers she has contacted wouldn't cover her. The few that offered her insurance wanted to exclude her arthritismedications and any health problems she might develop related to her rheumatoid arthritis.

At age 60, Frazier now faces the economically ruinous prospect of paying for the drug out of pocket. She is also considering coming off the drug and going on full disability when her symptoms return.

"As long as I am on the Enbrel I am perfectly healthy. Most of my clients don't even know I have rheumatoid arthritis," she says. "But I've had the discussion with my doctor about what will happen if I have to stop taking it."

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