research finds many children may forego health care because of cost

Children who were insured, but believed to be “underinsured” will forego medical advice and follow up because they were unable to pay for the care recommended, as reported in a study conducted from 2009 to 2010 and recently published online in The Journal of Pediatrics.

John Pascoe, MD, pediatrician at The Children’s Medical Center of Dayton and professor of pediatrics at Wright State University Boonshoft School of Medicine, William Spears, PhD, associate professor of community health and pediatrics at the school and others interviewed almost 3,000 parents in Southwestern Ohio who were insured and had children six months old or older. What they found was:

• 17.2 percent of the children in the study were underinsured (unable to pay for the care recommended by a physician)
• 15.5 percent of parents said it had become harder to get the care their children needed
• 6.5 percent of parents felt their children’s health had suffered because they couldn’t get this care.

In addition, the researchers also found the perception that an underinsured child’s health had suffered was greatest in the higher socioeconomic categories with 93 percent of these families reporting they were underinsured in 2009.  The researchers concluded high deductible health insurance plans may have contributed to this circumstance.

“I was concerned, even before the recession, that a lot of my patients with private insurance were struggling to follow my recommendations because of co-pays and high deductibles,” Pascoe says. “The mother of one of my patients just recently said, ‘I essentially don’t have health insurance; I have a $5,000 deductible that will save us from bankruptcy, but when we see you, we are essentially paying cash.’”

Spears says he was dismayed at the number of children they found to be underinsured. Before their interviews, the clinicians weren’t even aware of the magnitude of the problem.

“In Ohio, about 14 percent of kids are uninsured,” he says. “With health reform, we are saying we want to get them insured – but then we need to ask if this insurance is adequate.”

While the number of underinsured children has dropped slightly in 2011, it is similar to what was seen in 2009. The researchers hope this study will add to other work showing that, while it is important to make sure children have insurance, attention should be paid to children in families of all incomes who cannot get the care they need.

“This is an opportunity for change with health reform,” Pascoe says. “Insurers aren’t going to take care of it for us; they are in it for profit. We have identified a problem and the solution is a complex societal issue concerning whether or not we want to leave families bankrupt.”

Other contributors to the research and article include Harry Khamis, PhD, professor, community health and mathematics and statistics, Caroline I. McNicholas, xxx, and Greg Eberhart, MD, pediatrician and assistant professor of pediatrics. Parents’ Perspectives on Their Children’s Health Insurance: The Plight of the Underinsured  was accepted for publication in July 2012.

For more information, contact: 

Grace Rodney 

Marketing Communications Specialist 

Phone: 937-641-3666 

marketing@childrensdayton.org