A Harvard-based study of insurance coverage involving a nationwide sampling of people with multiple sclerosis found that although they had higher than average rates of insurance coverage, many experienced financial strain related to obtaining adequate health care, including paying for their medications.
The study, commissioned by the National MS Society, was conducted by Drs. Lisa Iezzoni and Long Ngo and published in an early online release January 29, 2007 in the journal Multiple Sclerosis.
Study Details: The study was the largest ever undertaken to explore insurance concerns in people with MS. It was based on 30-minute phone interviews with 983 working-age individuals across the U.S. with multiple sclerosis from among the client mailing list of the National MS Society. Most participants were women (79%), white (86%), married or living with a partner (67%), with at least some college education (72%), and unemployed (60%). Half reported having MS for greater than ten years, and most (73%) reported having relapsing-remitting MS. The authors suggested that, since these demographics mirror in many respects those from other well-designed studies, the results can be generalized to the MS population as a whole.
The interview covered questions about MS history, health insurance, disability and life insurance, as well as financial concerns related to obtaining MS medications and other health services.
Findings: A high percentage (96%) of survey participants reported having at least some health insurance, which is a higher rate of coverage than that of the general population, which for all ages is about 86%. However, there is a high level of dependence on governmental programs; about 40% of participants were covered by public health insurance, primarily Medicare and/or Medicaid, in contrast to only 12% of 44-54 year-olds nationwide. (Although this is a smaller age range than that of the study, it provides an approximate comparison.) In addition, about 68% of survey participants reported having life insurance, and 57% had some long-term disability insurance.
Despite the high rate of health insurance, a significant proportion of participants reported high levels of stress and difficulties related to affording health care services and medications. In order to pay for health care needs, 44% reported making other kinds of changes in their lives. Some 21% reported spending less on food, heat and other necessities to pay for health care needs, and 22% did not fill prescriptions or skipped doses of medicine. Over a third reported worrying "a lot" about losing or not having health insurance, about the cost of health insurance, and about whether their health coverage might change.
In writing about their results, the investigators stated that, "These findings suggest that health insurance is often inadequate to meet persons' needs." Commenting on the study, Dr. Nicholas LaRocca, Associate Vice President of Health Care Delivery and Policy Research at the National MS Society said, "This study emphasizes that simply having insurance does not necessarily ensure that a person will be able to afford care and medications that are so important for treating MS. It also confirms the importance of the â€˜safety net' and our ongoing efforts to improve health insurance coverage for people with MS."