Like other physicians, Gady Har-El, MD, Chairman of the Department of Otolaryngology-Head and Neck Surgery at Lenox Hill Hospital in New York and president of the American Broncho-Esophagological Association, takes on uninsured patients who have waited too long to see a doctor. I see people who are suffering from late-stage cancer, complicated comorbidities from smoking, and uncontrolled diabetes. With older patients, delays in treatment can be especially serious, he said.
Explore this issue:November 2007
For uninsured middle-aged Americans-those between ages 50 and 64-with chronic illnesses, the wait to receive Medicare at age 65 may be laden with nonreimbursable bills for doctor visits and hospitalizations. A recent New England Journal of Medicine article attempted to quantify just how much waiting for insurance costs a vulnerable population (Williams J, Meara E, et al. Use of health services by previously uninsured Medicare beneficiaries. NEJM 2007;357:143-53).
The authors collected longitudinal data between 1992 and 2004 on 5158 adults who were either privately insured continuously for five out of the six years immediately preceding their Medicare eligibility or uninsured before Medicare coverage began at age 65. They hypothesized that previously uninsured adults with chronic conditions who start receiving Medicare at age 65 have greater morbidity and require more intense and costlier care over subsequent years than they would if they had been insured previously.