Ed. Kinney et Sk. Steinmetz, NOTES FROM THE INSURANCE UNDERGROUND - HOW THE CHRONICALLY ILL COPE, Journal of health politics, policy and law, 19(3), 1994, pp. 633-642
This report from the field is an account of the experience of individu
als with multiple sclerosis (MS) in Indiana in getting and keeping pri
vate health insurance. The report presents the findings of a telephone
survey of individuals with MS in Indiana. While survey respondents we
re generally able to obtain health insurance through the Medicare prog
ram or employer-based private health insurance plans, many experienced
formidable barriers to adequate and affordable health insurance, such
as preexisting exclusions, cancellations, high premiums, and coinsura
nce. Respondents adopted a variety of strategies to keep private healt
h insurance, including selectivity in submitting claims, which worked
to reduce their health insurance coverage. Our findings raise two cruc
ial questions: (1) to what extent are the chronically ill forced to ta
ke extraordinary measures to get and keep health insurance? and (2) to
what extent do insurer practices in pricing insurance and determining
coverage of benefits actually make health insurance even more inadequ
ate and unaffordable for the chronically ill? These two questions are
critical in understanding the full dimensions of the health insurance
crisis in the United States today.