Uninsured in America: It's Getting Worse

(Ivanhoe Newswire) -- The latest data from the U.S. census bureau shows the number of uninsured people in America is at an all-time high at 46.6 million. One expert warns the problems of the health care system in America are getting worse.

The United States is the only major industrialized country without universal health insurance. Karen Davis, president of the Commonwealth Fund, reports health care coverage varies widely between states and inequalities in access to care and quality of care are rampant. According to Davis, the United States spends twice as much on health care as the median industrialized nations but still does not have the best quality care.

The Institute of Medicine reports 18,000 Americans lose their lives every year as a result of a gap in health care coverage. Most of the uninsured are people ages 18 to 64. In the analysis, Davis reports, "The average family premium for employer based cover is $11,480 a year. Employers have cut back on coverage and benefits in response to rising health care costs and adverse economic circumstances."

Davis also points out people who are uninsured or underinsured are more than twice as likely to report going without needed care because of costs. When they do get care, they often spend so much money on out-of-pocket expenses, the uninsured face financial hardship.

Expanding coverage in the United States would help people on low incomes who make up two-thirds of the uninsured, according to Davis. Several states have passed plans making health care coverage affordable for all uninsured residents. This is done by using state programs to subsidize care for the poor and by creating an "insurance pool" for small businesses and the self-employed.

Davis points out these programs are helpful, but are happening almost primarily in states with relatively low numbers of uninsured people. She says there is not much hope that the federal government will pass laws to make insurance mandatory and affordable for everyone.

Davis concludes, "What is clear is that the problem is getting worse, not diminishing. The fragmented, uncoordinated health care system is plagued by high administrative costs and missed opportunities to control chronic conditions and prevent life-threatening conditions. If the United States hopes to achieve a high-performance health system that is value for money, it will have to tackle the perplexing problems of access, quality, and cost and overcome considerable political and economic obstacles, as well as institutional resistance to change."

Karen Davis was head of health policy for the U.S. Department of Health and Human Services during 1977-81. She is also a former chairman of health policy and management at Johns Hopkins School of Hygiene and Public Health in Baltimore.

This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.

SOURCE: The British Medical Journal, 2007;334:346-348