Bookmark and Share

March 2009

The Crisis of the Uninsured and Resources on the Issue

As of 2007, the number of uninsured Americans totaled 45.7 million.  There is no doubt that this number has already increased in the face of recession and rising unemployment rates.  As the debate surrounding broad national health care reform heats up once again, it is a good time to be reminded of the consequences associated with having such a significant uninsured population.  A February 2009 report from The Institute of Medicine (IOM), “America’s Uninsured Crisis: Consequences for Health and Health Care,” responds to the question of whether health insurance actually matters to health and, more specifically, assesses the research evidence on the consequences of uninsurance, including health outcomes, access to health care services, and economic impacts.  This report follows a series of six reports that the IOM—with funding from The Robert Wood Johnson Foundation—issued between 2001 and 2004, as part of its project, "Consequences of Uninsurance," Some highlights of the IOM study include:  

  • Lack of health insurance leads to 18,000 unnecessary deaths each year;
  • Uninsured adults are less likely to get recommended health screening services;
  • Uninsured patients with cancer are more likely to die prematurely because of delayed diagnosis;
  • Uninsured persons with chronic conditions are less likely to have regular check-ups or get medication that control their disease; and
  • The financial, physical, and emotional well-being of all family members may be adversely affected if any member lacks coverage.

According to the IOM’s 2009 report, there is broad consensus that health insurance coverage is declining and that this decline is likely to continue without some sort of concerted action.  The IOM asserts that a substantial body of high-quality research has found that being uninsured is harmful, particularly for children.  The gap between the needs of people without health insurance and access to services to address these needs results in unnecessary illness, suffering, and death.  However, uninsurance does not just affect the health of those who are uninsured.  A range of research suggests that when rates of uninsurance are high within a community, insured adults in that same community are more likely to find it difficult to obtain needed health care and are less satisfied with the care they receive. 

For more information on the uninsured in the United States visit SCI’s discussion on Coverage and Reform, and the uninsured in the United States.

SCI has compiled a small set of recent articles and reports that highlight data about the uninsured in the current landscape:

Why Health Insurance Is Important
The Urban Institute
November 2007

Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families—Findings from the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2007
The Commonwealth Fund
August 2008

Seeing Red: The Growing Burden of Medical Bills and Debt Faced by U.S. Families
The Commonwealth Fund
August 2008

Five Basic Facts on the Uninsured
Kaiser Family Foundation
September 2008

Health Coverage in a Period of Rising Unemployment
Kaiser Family Foundation
December 2008

Rising Unemployment, Medicaid and the Uninsured
Kaiser Family Foundation
January 2009

Health Spending Projections through 2018:  Recession Effects Add Uncertainty to the Outlook
Health Affairs
February 2009

Kaiser Health Tracking Poll
Kaiser Family Foundation
February 2009