The New York Times is reporting that large U.S. healthinsurers are seeing record profits for the third year in a row, duein large part to Americans who are postponing or forgoing care.

As Americans remain wary of economic recovery, they have becomemore discerning about going to the doctor or scheduling neededhealth care.

“I am noticing my patients with insurance are more interested incosts,” said Dr. Jim King, a family practice physician in ruralTennessee. “Gasprices are going up, food prices are going up. They aredeciding to put some of their health care off,” he said.

Despite the high earnings, insurers continue to defend premiumincreases, “even though their reserve coffers are flush withprofits and shareholders have been rewarded with new dividends,”according to the Times.

Insurers price premiums much on what they anticipate to pay outin future claims and say they expect demand to increase later thisyear. “I think there’s a real concern about a bounce-back, arebound, in utilization,” said Dr. Lonny Reisman, the chief medicalofficer for Aetna.

“Because they say they expect costs to rebound, insurers havenot been shy about asking for higher rates,” according to theTimes.

Other factors spurring Americans to put off care are increaseddeductibles and copayments and reduced benefits for employer-sponsored health insurance plans,which have been rising over the past several years.

Some experts surmise that companies are trying to raise premiumsbefore health care reform regulations are enacted, while othersmaintain that costs will continue to rise, but that insurers aremore accurately predicting costs and making room for profits,reports the Times.