Coverage Matters

At its best, the United States health care system is second to none. It is quick to adopt and diffuse new technologies.¹ It scores best in the world for patient participation in treatment decisions, respect for confidentiality, provision of prompt care, respect for patients, and clean surroundings.² But despite having the highest health care spending per capita, the U.S. consistently scores at or near the bottom in comparisons with other developed, high income countries on infant mortality, life expectancy, and the proportion of the population with health insurance coverage (OECD, 2002, WHO, 2000). Almost everyone in these countries has coverage. In the U.S., by contrast, 15.8 percent of the population -- or 47 million people -- were uninsured in 2006.³ What are the consequences of 36.7 million adults and 8.1 million children living without health insurance coverage?

In a sweeping 6-volume series on the consequences of uninsurance, the Institute of Medicine reported the following conclusions:

• Compared to people with insurance, uninsured children and adults experience worse health and die sooner.
• Families can suffer emotionally and financially when even a single member is uninsured.
• "Uninsurance at the community level is associated with financial instability for health care providers and institutions, reduced hospital services and capacity, and significant cuts in public health programs, which may diminish access to certain types of care for all residents, even those who have coverage."⁴
• The nation as a whole is economically disadvantaged as a result of the poorer health and premature death of uninsured Americans. The IOM estimated that the lost economic value of uninsurance is between $65 billion and $130 billion annually.⁵