Attitude toward medical care and health insurance among uninsured older adults

Objective: This study highlights attitude toward medical care and health insurance among older uninsured individuals, as well as their healthcare needs, expenditures, and out-of-pocket (OOP) financial burden. Despite greater devastating effects of being uninsured among older adults aged 65 or older, few studies focused on this age group due to almost universal coverage of Medicare. Older adults covered by both Medicare and private insurance consist of a comparison group. Methods: The pooled 2000-2007 Medical Expenditure Panel Survey was analyzed (N= 27,429). The STATA SVY procedures were used to account for the complex sampling design. Results: About 0.4% of U.S. older adults were uninsured all year (95% CI=0.3%-0.5%), while 46.5% (95% CI=45.1%-47.9%) had both Medicare and private insurance for whole year. Interestingly, the uninsured were more likely to agree that they did not need health insurance (24.1% vs. 4.3%), health insurance was not worth the cost (36.9% vs. 13.5%), and they were more likely to take risks than others (33.4% vs. 14.4%). A logistic regression model indicates that the uninsured were more likely to be foreign-born, younger, low income, African American, Hispanic, and had a lower number of chronic conditions. After controlling for predisposing, needs, and enabling factors, the uninsured displayed lower total and OOP medical expenditures. However, their OOP financial burden, expressed by the percentage of income spent on OOP medical expenditures, was much greater among the uninsured (43.1% of income vs. 10.8%). Conclusion: Even though the number is small, uninsured older adults should receive further attention from health professionals.