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Many people in the United States are not able to afford an annual physical exam. Some people never get one because they are afraid of what they may find out about their health. These fears can cause some people to avoid doctors altogether. A recent study revealed that almost 2 million Americans are uninsured, which means that many more get by with no or fewer health screenings. This trend has led to a decrease in population screening rates, which leaves more of them vulnerable to developing serious conditions like diabetes and heart disease, but at least some healthy preventative care is still being done on a regular basis for most Americans through doctors' visits. Even those who have insurance may not be able to afford a visit to an annual physical. About 40 million people who are considered uninsured do have access to medical care through the system of public health programs, but a new study has shown that these programs do not provide as much preventive care as they could. This is especially true for those that are uninsured or underinsured. In the United States, about one-fifth of the population - around 49 million people - is uninsured at some point during any given year, with an additional 14 million being underinsured for some portion of the year, according to a report by researchers from Harvard Medical School and Partners HealthCare Center for Social Design. The report, which was published in the journal Health Affairs, indicates that relying on free clinics and emergency rooms to provide medical care to the uninsured and underinsured is not enough and is actually doing more harm than good. According to health experts, the uninsured experience worse health outcomes than those who have access to insurance. The United States is one of the few countries in the OECD with a large number of people lacking illness coverage. In 'the few countries without universal coverage... such as Mexico, Turkey and Chile... many sick patients remain uncovered.' The study also found that about 45% of all personal bankruptcies in the country resulted from unpaid medical bills. This could be because many Americans who are not insured do not have the resources to pay for expensive medical treatments. However, in 2008, there were 5.9 million bankruptcies in the United States, according to data from the American bankruptcy court system. Of these, almost 1 million ended because of medical bills. 'Of the 2 million people who filed personal bankruptcies in 2008 because of unpaid medical bills, about half had health insurance,' according to a report by CNN. Environmentally-friendly choices are often restricted due to cost. Several healthy options are available at low cost compared with conventional medicine approaches which provide little if any relief for patients who suffer from chronic pain and other debilitating conditions. The estimated cost to develop an effective NSAID based cancer pain medication is $2 million. The number of people suffering with cancer afflictions is estimated to increase by 30% in the next ten years. Finding a treatment that works for a specific person takes more research time and money than many can afford. For some, life goes on while they continue to suffer from the side effects of the original illness or injury that caused their pain and suffering. Because of these prohibitive costs, some people choose not to pursue medical treatment, resulting in their health status deteriorating further, contributing further to the larger problem of health care costs being so high compared with other nations. cfa1e77820