A quarter of privately insured working-age adults say their health care is unaffordable, according to the latest Commonwealth Fund Health Care Affordability Index  released Nov. 20. The report, "How High Is America’s Health Care Cost Burden?" is based on an annual Commonwealth Fund survey of U.S. adults’ health costs. According to the survey, health plan deductibles and copayments had negative effects on many people’s willingness to get needed health care or fill prescriptions. Some 40% of adults with deductibles that amounted to 5% or more of their income said they put off going to the doctor when sick, skipped preventive care and recommended follow-up tests or didn’t seek specialist care. In addition, the survey found many consumers are confused about which services are free to them and which count toward their deductible. “More Americans than ever have health insurance, but these findings show that too many people with all types of coverage aren’t getting care because of high costs,” said Commonwealth Fund President David Blumenthal, M.D.