Medical expenditures and insurance coverage for people with diabetes: estimates from the National Medical Care Expenditure Survey

Access to health insurance and protection against expenditures for medical care are of special concern to diabetic patients in the United States. This study examines some information on the extent and breadth of public and private health insurance for individuals with diabetes, as well as some estimates of their use of health-care services and their mean expenses for this care. About 12% of all diabetic patients less than 65 yr old (approximately 311,000 individuals) were uninsured throughout 1977, a rate not much different from that for the rest of the United States population. Those with diabetes who are uninsured tend to be younger, Black or Hispanic, in excellent or good health, and live outside of metropolitan areas and in the South or West. As expected, diabetic patients use more medical care than others of their age and sex, and their medical expenses are also much higher, particularly in younger age groups. In 1977, average total medical-care expenses for people with diabetes were $1514 compared with $548 for the rest of the population. They and their families paid approximately 20% out of pocket (approximately $355). Their health insurance premiums were not much different from those without diabetes, averaging approximately $1000 in 1977 for those under age 65. The private insurance coverage for diabetic patients was similar to that for others, although slightly fewer had major medical coverage than the general population.