HEALTH CARE COSTS ON RISE FOR INSURED PATIENTS OUT-OF-POCKET MEDICAL EXPENSES HAVE JUMPED SINCE THE 1980S INSURANCE NO LONGER GUARANTEES PROTECTION FROM FINANCIAL RUIN.(MAIN)

Byline: ELISABETH ROSENTHAL New York Times

NEW YORK Patients covered by what they thought was comprehensive medical insurance are increasingly facing large out-of-pocket costs as insurers and employers turn to them to help pay the nation's ever-rising health care bill.

Personal outlays for medical care have risen steadily since the early 1980s, but the trend has accelerated in the last several years, with 1994 estimates showing yet another leap.

And patients are discovering that merely having insurance is no surefire protection from financial hardship or even ruin. In a survey of 1,623 households published in March in The Journal of the …