Inability to pay for pediatrician-recommended care is problem even in families with health insurance

American Academy of PediatricsOct 4 2010

One in eight parents reported that his or her child had not received pediatrician-recommended care - medication, laboratory testing and/or appointments with specialists - during the previous 12 months due to concerns over cost and payment, according to a study, presented Sunday, Oct. 3, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in San Francisco.

For the study, "Parents Perspectives on their Children's Health Insurance: The Plight of the Underinsured," 1,978 southwest Ohio parents were queried regarding the impact of their children's health insurance on their ability to follow pediatric recommendations, as well as on their child's health. Children were considered "underinsured" if their parents had not been able to follow at least one recommendation from a pediatrician during the previous 12 months due to insufficient insurance coverage.

Forty-two percent of parents with underinsured children agreed with the statement their "child's health had suffered because of not being able to afford the cost of the needed care," compared to less than 2 percent of parents who were not underinsured

The study also found that private insurance is a risk factor for underinsurance. After controlling, for annual family income and health status, children with private insurance were about twice as likely as children with public insurance to be underinsured. In addition, children with poorer health or from poorer families (those with household incomes between $15,000 and $34,999) were at greater risk for underinsurance than children who were healthier or from wealthier families (household earning more than $75,000 annually).

"These results serve to highlight a major public health problem pediatricians have observed for years," said John M. Pascoe, MD, MPH, FAAP. The investigators believe that the explanation for the high level of child underinsurance among lower income families whose children do not qualify for public insurance is the high deductibles and co-pays imposed by their private insurance companies. Many parents believe their children's health has suffered as a direct result of their inability to afford recommended care for their underinsured children."