Uninsured According to the Institute

Uninsured

According to the Institute of Medicine in January 2000 there were 40 million uninsured Americans. By 2004 the number had grown to 43 million and this increase took place during a prosperous economy. On September 17, 2010, USA Today jounralist Richard Wolf quoted a U.S. Census Bureau report saying there are now more than 50 million U.S. residents, which is about 17% of the total population. This jump can be attributed to the loss of approximately 1 million jobs in the American economy since 2008.

In addition to the growth of uninsured individuals and families, there has been a growth in the number of underinsure people. Underinsurance can be described in a couple of ways, the most prevalent is people who are covered by catastrophic insurance only. A second way is for incomplete family coverage, meaning that at least one family member is not insured. Both of these lead to significant financial risk to the underinsured individual and/or incomplete insured household. Currently, most people who are insured are on an employer- sponsored policy. Employer based insurance was one of the first attempts to increase the number of Americans with health insurance. In the sixth issue of the 2005 Health Affairs journal, Donald W. Moran describes the history of employer-funded health insurance in his article Whence and Whither Health Insurance? A Revisionist History:

"Modern private health insurance began in the 1930s and quickly expanded as an employee fringe benefit when wage and price controls were implemented during the Second World War. By the 1960s, employer-based health insurance had become the dominant U.S. mode of health care financing. Even today, when workplace-based health insurance coverage is perceived as being under siege, nearly 90% of private-sector employees have access to some form of offer of health insurance financing from their employers"

With growing joblessness, increased self-employ and skyrocketing costs of healthcare, nearly 50 million Americans are uninsured. As an unemployed or self-employed person it is difficult and expensive to obtain health insurance. Employed individuals and their families are part of a risk pool made up of all the company's employees which results in reduced rates due to reduced risks. An individual who applies for insurance does not have the advantage of a risk pool and are therefore, a greater risk for the insurer. If the individual is lucky enough to obtain coverage, their rates will be significantly hire due to the increased risk and the lack of bargaining power possessed by a large company.

These disadvantages also impact small companies who often don't offer health insurance due to the high prices offered to them. The decision to not offer insurance has a large impact; 55% of uninsured Americans having at least one person in the household employed. Another factor, which increases the number of working uninsured, is the increase of healthcare costs. According to the Kaiser Family Foundation, employees costs have risen by 47% and employers have seen a 20% increase. The employee's higher percentage can be attributed to the fact that employers are shifting some of the increased costs to the employee through higher deductibles and increase co-payments.

The U.S. government, at both the state and federal level attempt to help the poor, the elderly, the disabled and uninsured children through the Medicare, Medicaid, and the Children's Health Insurance Plan (CHIP) programs. Unfortunately, if you live above the poverty line and are between the ages of 18-64 there is very little help available.

Being uninsured means a lower quality of life and a decrease in the length of one's life. According to the Institute of Medicine, one in five adults without health insurance report to be in fair or poor health; for people with continuous healthcare coverage the statistic is one in nine -- almost double. The Institute provides four examples of the personal health costs of not having continuous healthcare coverage:

"1) Uninsured adults have a 25% greater mortality risk than adults with coverage. About 18,000 excess deaths among people younger than 65 are attributed to lack of coverage every year. This mortality figure is similar to the 17,500 deaths from diabetes and 19,000 deaths from stroke within the same age group in 2001.