Nearly half the nation's adults who lack health insurance have trouble obtaining or paying for medical care and suffer serious health or financial problems as a result, according to a study in today's Journal of the American Medical Association (JAMA).

The finding disproves the widespread popular notion that the uninsured get adequate health care and the public simply picks up the bill, said Drew Altman, president of the Kaiser Family Foundation. Altman's group, together with researchers at Harvard University and the National Opinion Research Center, conducted the study using 1995 telephone surveys of 3,993 randomly selected persons nationwide.

"Even today, the vast majority of Americans believe the uninsured get the care they need," with doctors, hospitals and emergency rooms providing it free, Altman said at a news conference here, citing public opinion polls conducted this summer. But he said the study shows the reality to be far different.