Underinsurance in America

To the Editor: Dr. Bodenheimer's Sounding Board article on underinsurance (July 23 issue)¹ is on target when it emphasizes that underinsurance is as great a problem of the nation's health care system as lack of insurance. He alludes only anecdotally, however, to one of the highest out-of-pocket expenses incurred by patients — outpatient prescription medications.In our university-based hematology and oncology practice, we have found that a lack of coverage for outpatient prescription drugs affects both the quantity and quality of pain medications prescribed.^{2 , 3} Patients without such coverage are less likely to receive sustained-release morphine compounds, which have been shown . . .