Jayne O'Donnell

USA TODAY

Working people don%27t suffer from anxiety much%2C but their families do

It costs more not to treat the sick than it does to treat them%2C many say

Depression bedevils those without insurance%3B so does obsessive compulsive disorder

Consumers on Medicaid or Medicare are much more likely to have chronic diseases — including diabetes and heart disease — than the overall population. The uninsured, on the other hand, suffer from depression, obsessive-compulsive disorder and dyslexia more often than others. And the working insured have just one ailment more than everyone else: acid reflux.

These are among the findings of a new study of the health care challenges facing more than 15,000 consumers, coming out Tuesday from consumer research company Prosper Insights & Analytics.

The new data confirm that those on Medicaid and Medicare have more illnesses than people who are uninsured, but the report includes some revelatory findings on the ailments affecting those with different types of insurance coverage.

For example, those covered by employer plans made up 40% of the survey respondents and were the healthiest group. Working may be stressful, but having a job clearly lessens most medical symptoms of stress.

The working insured were below the general population in their likelihood of anxiety, depression and heart disease and within the expected range for high blood pressure. The dependents on their plans, however, had more anxiety than average.

And acid reflux, which is often attributed to obesity, a bad diet and a lack of exercise, remains the one ailment that sets these workers apart from the rest.

Medicaid and Medicare patients are at least 10% more likely than the population to file claims for 22 out of 26 health ailments, and they are only below the population in their likelihood to file for two conditions — dyslexia and headaches/migraines. They are in the expected range for allergies and obsessive-compulsive disorder.

"Clinical needs are more diverse and more complicated than people might imagine," says health care consultant Kip Piper, a former Medicare and Medicaid official in Wisconsin and Washington, D.C.

One of the key things the data show is how the expansion of Medicaid under the Affordable Care Act could prove costly to the federal government, which is footing nearly all the cost of Medicaid expansion for the states that agreed to do it.

But the alternative would be far more expensive, says Sarah Dash, a research fellow at Georgetown University's Center on Health Insurance Reforms. Getting sick people health insurance so they aren't falling in and out of coverage was a goal of the law, after all, she says.

"We need these kinds of analytics to figure out how to better manage chronic diseases and improve population health," says Dash. "We need to be more aggressive in preventing diabetes from progressing, but we're not going to solve the problem. We're nowhere near the low-hanging fruit yet."

The research should help insurers, pharmaceutical companies, retailers and government officials better understand the various consumer segments so they can target their educational messages, says Prosper executive vice president Phil Rist. The data show both where the problems lie and the areas of opportunity for marketers, he says.

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