As lawmakers examine ways to change the health insurance landscape, including renewing the push for Medicare for All, a new study shows that publicly sponsored insurance programs may have a leg up on private insurance.
The study, published online Tuesday in JAMA Network Open, shows that people with private insurance were more likely to report poor access to care, higher costs and lower satisfaction levels compared with those covered by public insurance plans.
In fact, individuals covered by Medicare more commonly reported having a healthcare provider (91.7%) versus those covered by other programs, like employer-sponsored (80.7%) and individually purchased (79.9%) plans.
Further, reports of medical debt were more common among people who had employer-sponsored private insurance coverage (23.4%) and those with individually purchased private plans (22.3%) than individuals covered by Medicare (15.6%) or Medicaid (18.3%).
For the study, researchers from the University of California, San Francisco and San Francisco Veterans Affairs Medical Center used data from the 2016-2018 Behavioral Risk Factor Surveillance System, a state-based telephone survey. They gathered data on 149,290 individuals across 17 states.
Of these, most were covered by private insurance (63.9%), followed by Medicare (23.8%) and Medicaid (8.9%). About 79% of those with private insurance had employer-sponsored coverage.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
In general, people with employer-sponsored insurance were less satisfied with their coverage. They were more likely to report instability in coverage, difficulty in seeing a physician because of cost and not taking medication due to cost than Medicare beneficiaries.
Comparing private insurance with Medicaid, on the other hand, resulted in some mixed findings. Those with employer-sponsored insurance were more likely to report having medical debt but were less likely to say they found it difficult to see a physician because of costs. But there was no difference in satisfaction with care between individuals with these types of coverage.
It is important to note that the mixed findings could be the result of the varying benefits Medicaid programs provide across states, the study authors wrote.
The debate over health insurance reform is nowhere near over. But as policymakers continue to examine new strategies they should consider “efforts directed at increasing the number of individuals covered by Medicare or improving protections for individuals covered by private insurance against increasing out-of-pocket costs, high deductibles, and surprise billing,” the study authors wrote.
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