NEW YORK CITY: Survey Finds Uninsured Face Difficulties

      Despite living in the shadow of some of the finest medical centers in the world, many uninsured New York residents have difficulty obtaining health care services, according to a survey released yesterday by The Commonwealth Fund. The survey, which was conducted by Louis Harris and Associates, finds that New Yorkers without health insurance are much more likely to face barriers to health care, medical bill problems, and lower quality health care. One in four adults in New York City -- more than one million women and men and one in six children -- were uninsured at the time of the survey. According to the survey, adults ages 18 to 64 in New York City are more likely to be uninsured than adults of the same age in either New York state or the nation, and they are far less likely to have insurance through their jobs. According to the survey, this is because so many jobs in the city are in the retail, service and entertainment sectors, which often do not provide insurance. Karen Davis, president of The Commonwealth Fund, said, "The erosion of employer-based coverage in New York City is particularly troubling. We cannot rely on lower unemployment rates to solve the health care crisis or assume that private insurance will be there for people who work."

More Findings
      The survey notes that being uninsured is strongly linked to problems in obtaining access to health care: uninsured New Yorkers are two to three times more likely to have difficulty getting access to care (53% vs. 14%) and to report not getting needed care (19% vs. 7%) than the insured. Access to preventive care is also dependent on insured status: among uninsured adults ages 50 to 64, 75% of men had had no prostate exam and 58% of women had had no mammogram in the past year. James Tallon, Jr., president of the United Hospital Fund of New York and a board member of The Commonwealth Fund, said, "We must come up with long-term solutions for reaching out to working families."

TCF Survey On Public Hospitals And Poverty
      The survey found that New York City's public hospitals, emergency rooms, and clinics form an important network of care for uninsured and low income people. When they require hospitalization, 48% of New York City's uninsured are admitted to public hospitals, compared with 13% of those privately insured. The uninsured are more than twice as likely as the privately insured to use a public hospital emergency room. The survey also revealed that the city's public hospital system enjoys widespread support. Fifty-eight percent of those surveyed said that selling or closing the city's public hospitals would be a "bad thing." Finally, the survey found strong links between problems with health care access, paying medical bills and low incomes. While 44% of poor working-age adults said they had not received needed medical care and/or had had a problem paying medical bills, only 34% of those above 250% of the poverty level reported such problems. The connection between income and access was also reflected in the disparity between health care coverage and access experiences of New York City minorities compared with the white population. While 28% of black and 38% of Hispanic working-age adults reported difficulties getting medical care, only 19% of white working-age adults reported such difficulties. Cathy Schoen, director of research and evaluation for The Commonwealth Fund said, "Clearly, New York City does not lack health care resources. We have to find ways of reaching out to the working poor. Recent proposals to expand child health coverage are a step in the right direction, but we need to reach the entire family." The Commonwealth Fund Survey of Health Care in New York City was conducted from October 1996 through March 1997, and included interviews with some 4,000 people age 18 and older. The survey included 3,750 telephone interviews and 263 in-person interviews. It was co-sponsored by The United Hospital Fund of New York (release, 2/11).