Survey Finds Public Highly Insecure About Health Care : Medicine: About 2.7 million in state will spend 10% or more of their incomes on medical services not covered by insurance, report indicates.

About 2.7 million Californians will spend 10% or more of their incomes on health services during 1993, even though most of them will be covered by some kind of public or private medical insurance, a new study on national health trends reported Thursday.

The results are contained in a report by the Families USA Foundation, which shows that 46% of U.S. families have a member who either will have no health insurance at some point in 1993 or who will spend 10% or more of their income to pay medical bills.

In California, that figure is slightly higher, with 48.8% of the state’s families having an immediate family member who will go without health insurance this year or who will end up paying high out-of-pocket medical expenses, the report said.

“There is tremendous insecurity in the American public’s mind about health care. Americans are very worried that health care won’t be available to them when they need it. This report shows they have reason to be concerned,” said Ron Pollack, executive director of Families USA, in a telephone interview from his office in Washington, D.C.

Families USA is a health care consumer group said to be highly influential with health officials in the Clinton White House. The newest study is based on nationwide statistics collected by two federal agencies and analyzed by foundation researchers.

The report suggests that gaps in health insurance coverage are worse than previously believed.

Families USA, tracking individuals at four points over a full year, said that 57.3 million Americans, including 8.6 million Californians, will be without health insurance at some point during 1993 because of job changes or other factors. This is considerably higher than previous estimates, which have represented snapshots of the population at one point in time and have not counted people who may be uncovered for periods because of job movement or changes in coverage.

Adding to the problem of the uninsured are 25 million Americans, 2.7 million of them in California, who will have to spend 10% or more of their incomes on health expenses, the report said. That estimate does not include money spent to pay for health insurance premiums, nursing home costs, Medicare payroll taxes or other state, federal and local taxes to pay for health care.

Of those Californians faced with large out-of-pocket expenses, 36% are younger than 65 and covered by private individual or group health insurance policies. The rest are the elderly covered by Medicare and the poor covered by Medicaid, known as Medi-Cal in California. Researchers said 28.4% of the group had no coverage at all.

Pollack said the elderly face heavy out-of-pocket expenses because Medicare and supplemental policies purchased to fill the gaps in their Medicare coverage often do not cover prescription drugs or long-term care delivered at their homes.

As for those under 65 who have private health insurance, Pollack said Americans are paying more because of ceilings in many plans, a lack of coverage for mental health treatment or preventive care, and extra costs shifted to employees by employers in the form of larger co-payments or deductibles.

“Even for those with insurance, there are lots of different ways that you can still fall through the cracks,” he said.