Healthcare costs are a major factor in almost every household budget.  Costs associated with a single hospital stay may quickly wipe out savings and move people into debt.  Thus, having some reliable and comfortable way of covering major medical expenses is an important element in preserving our quality of life.  It is thus instructive to examine how people tend to pay for hospital admissions.  

Between 1995 and 2000, the rate of hospital care admissions covered by commercial insurance or HMO policies remained fairly steady at 43%.  At that point, the percentage began to trend downward to 2005, when 40% of hospital care was covered by traditional insurance and HMO policies.  By 2010, this overall rate dropped further to 37%.  In contrast, the trend has been just the reverse for Medicare coverage: 37% in 1995, 42% in 2005, and almost 43% by 2010.  Similarly, the trend for reliance on Medicaid has been upward since 2001.  In 2005, about 12% of hospitalizations were covered by Medicaid. That is a two percentage point increase from 2000.  In 2010 15% of hospitalizations were covered by Medicaid.  

As should be expected, the shift over the past decade between reliance on commercial insurance and Medicare has been more dramatic for adult hospitalizations.   Between 1995 and 2000, the percent of hospitalizations were covered by private insurance actually rose from 41% to 44%.  However, there has been a steady decline since then.  In 20005, the rate was 37% and in 2010 was down to 35%.  In contrast, the percent covered by Medicare rose steadily between 2000 (44%) and 2010 (47%).  The aging of the Long Island population clearly accounts for this shift.  It is also worthy of note that adult Medicaid rates were generally the same in 1995 and  2005(10%); although the trend indicates that a slight dip occurred in the 1980s.  However, between 2007 and 2010 the percentage of adult hospitalizations covered by Medicaid rose about 30% (from 10% to 13%).  It is quite likely that this trend reflects the impact of the financial collapse that began in 2007.  As recent census data confirm, poverty on Long Island is on the rise.

For pediatric care, there has been a similar decline in the use of commercial insurance and HMO plans.  In 1995, 66% of pediatric hospitalizations, and in 2000 69% of pediatric hospitalizations were paid for by private insurance.  However, by 2005 the rate had dropped to 65%, and by 2010 to 64%.  In contrast, reliance on Medicaid for pediatric hospital care has increased.  Medicaid was utilized for 24% of pediatric hospital care in 1995.  In 2005, Medicaid payments accounted for 28% of pediatric care.  By 2010 the Medicaid rate was 32%.  That reflects an overall increase of 33%.  The sharpest rise actually occurred relatively recently between 2006 and 2010 (a four-year increase of 19% from 27% to 32%).  That can be attributed largely to the Great Recession sparked by the financial meltdown beginning in 2007.  The fact that almost one third of in-hospital care for Long Island children in 2010 was paid for by Medicaid is a significant indication of the spread of poverty and its impact on our young people.