North Carolina’s Uninsured

2000 - Institutional Event

Everett Cline suffered an unfortunate chain of events: he suffered a heart attack, lost his job and found himself without health insurance. But Cline was also among the more fortunate of North Carolina’s 1.3 million uninsured residents. He received the medical care and prescriptions he needed at one of the many free clinics that are part of the North Carolina Association of Free Clinics and supported by a grant from the separate and independent BCBSNC Foundation.

Everett Cline’s story represents a growing health problem that has become a key economic and political issue as well. According to 2006 Census Bureau data, the number of uninsured Americans has reached 47 million, including more than 8 million children. In a ranking by state, North Carolina has one of the fastest-growing uninsured populations in the country.

What does it mean to be uninsured? In many cases, it means reduced access to preventive care as well as medical treatment, a greater risk of developing serious illnesses, more hospital stays, and lower productivity at work. For uninsured women with breast cancer, it means a 30 to 50 percent higher risk of dying. And overall, the uninsured have a 25 percent greater risk of premature death.

Cost is the number one reason why so many people don’t have health insurance. But lack of awareness about publicly funded programs is a close runner-up. Many who are eligible for health insurance through Medicaid and NC Health Choice simply don’t sign up. Whether they haven’t heard of the programs, can’t complete the application process or feel that public programs carry a stigma, they miss an opportunity to lead healthier lives.

Information provided by BCBSNC.

Everett Cline, one of the uninsured North Carolinians who found help at a free clinic. Photo courtsey of the North Carolina Association of Free Clinics.

Taking Steps Toward Solutions

The problems of North Carolina’s uninsured have been decades in the making. But Blue Cross and Blue Shield of North Carolina is taking steps to make health care coverage more accessible and affordable for everyone by:

• Saving subscribers nearly $10 million in 2006 through reduced fraud, waste and abuse within the state.
• Making prescription drugs more affordable with incentives to use generic drugs, and programs such as electronic prescribing.
• Helping members make good diet and lifestyle choices, manage chronic conditions and save money through our Member Health Partnerships^SM.
• Helping businesses and individuals enter the health insurance market by realizing the savings and tax advantages of Health Savings Accounts.
  

The Blue Cross and Blue Shield of North Carolina Foundation —a separate, independent, private charitable foundation—is making a significant difference in improving the health of the uninsured. Through a partnership with the North Carolina Association of Free Clinics, they have helped to significantly increase the number of free clinics. The Foundation also collaborates with the NC Medical Society Foundation to recruit primary health care providers to rural and other high-need areas of the state. The partnership is expected to generate millions of dollars in care for the uninsured over five years.

Information provided by BCBSNC.

Where High Costs Come From

Simply put, health care coverage is just too expensive for the majority of North Carolina residents who are uninsured. Many families have to choose between paying for basic, everyday necessities and medical coverage that seems less urgent. Small businesses may have to weigh the cost of providing employee health insurance against making enough profit to keep the doors open.

Of course, insurance costs have risen because of soaring health care costs. Between 1990 and 2000, the cost of hospital care more than doubled. And while new medical technology and pharmaceuticals have helped diagnose and treat millions, they have also added billions to health care expenses. Prescription drug use and prices increased dramatically during the ’90s, pushing drug spending 250 percent higher. More recently, spending on diagnostic imaging such as CT scans, MRIs and PET scans increased by 21 percent in two years.

Another factor in health care spending is the rise of heart disease, cancer, diabetes and chronic obstructive pulmonary disease. These four diseases generate a billion dollars in health care costs among Blue Cross and Blue Shield of North Carolina members alone. Since some of the conditions often stem from improper diet, unhealthy weight, sedentary lifestyle or tobacco use, they can be largely preventable. In fact, adults in North Carolina spend an estimated $24.1 billion each year in health care costs related to physical inactivity, excess weight, type II diabetes and low consumption of fruits and vegetables.

Information provided by BCBSNC.

Who are the Uninsured?

The 15.6 percent of North Carolinians without health coverage come from every socioeconomic class, every race and religion, every level of education and every region of our state. They are employed, self-employed and unemployed. And all face very real health and financial risks.

Adults from 18 to 34 are the most likely to have no health insurance. Because they’re young, they may earn lower wages or simply assume they won’t get sick. Without coverage, they may neglect preventive care and routine checkups, leading to health problems later.

Among working people, employees of small companies receive fewer health benefits. Generally, small companies don’t qualify for low rates available to larger businesses. This is a serious problem in North Carolina, where 98 percent of all businesses are small and more than half don’t offer health insurance.

Although fewer in number, racial and ethnic minorities are more likely to be uninsured. Many work for small companies that don’t provide coverage or offer it at a high cost to employees. People from non–English-speaking countries may face language barriers. Many received health coverage from government-sponsored plans in their country of origin and don’t realize they need to sign up for it here.

You might think only low-income people lack health insurance. But the fact is that 9.3 million uninsured Americans have an annual household income above $50,000—and more than half of those earn at least $75,000 per year. Even at these income levels, health insurance costs can be challenging—especially for those with serious health conditions who don’t have access to group coverage. These “high-risk” people can be rejected for individual coverage or offered coverage at unaffordable prices.

Information provided by BCBSNC.