Our Broken Health Care System

Health care is an essential safegaurd of human life and dignity and there is an obligation for society to ensure that every person be able to realize this right.

— Joseph Cardinal Bernardin, Chicago Archdiocese

Almost 46 Million Americans Have No Health Insurance

Lack of health insurance is a growing problem for Americans today. The most recent figures from the Census Bureau indicate that 45.7 million people (15.3 percent of the population) were uninsured in 2007, a small improvement from 47 million (15.8 percent) in 2006. The improvement appears to be attributable to increased enrollment in government programs such as Medicare, Medicaid and the State Children’s Health Insurance Program (SCHIP).

The problem is worse than this data suggests. First, job cuts and the general economic decline in 2008 and 2009 caused workers to lose employer-provided insurance. Second, the 45.7 million number cited above is a snapshot. Families USA says, “A staggering 86.7 million Americans — one out of three people under 65 — were uninsured at some point during 2007–2008.” The report is Americans at Risk: One in Three Uninsured.

For many of the uninsured, the lack of health insurance has dire consequences. The uninsured often go without necessary care, and collect severe medical debt. The Urban Institute estimated that 22,000 adults died in 2006 because they did not have health insurance.

The Census number of uninsured is a snapshot of a single point in time. Families USA released a report in March 2009 titled Americans at Risk: One in Three Uninsured. This report shows that 86.7 million Americans were uninsured at some time during 2007 and 2008. Millions more are underinsured. An August 2008 report from the Commonwealth Fund shows that in 2007, nearly two-thirds of U.S. adults, or an estimated 116 million people, struggled to pay medical bills, went without needed care because of cost, were uninsured for a time, or were underinsured (i.e., were insured but not adequately protected from high medical expenses).

Most Americans assume that Medicaid covers all needy poor people. The fact is that federal law prohibits Medicaid from covering adults unless they are pregnant, caring for dependent children, severely disabled or elderly. About 9 million low-income adults are ineligible. See the Medicaid page for more.

Many of the uninsured are children. The U.S. Census found that 8.1 million children did not have health insurance in 2007. Children who do not have health insurance are eight times less likely to have a regular source of health care, four times more likely to delay treatment, and five times more likely to use the emergency room as a regular source of care. Even those children who are insured under government programs are at risk due to poor quality care.

Over sixty percent of uninsured children are racial or ethnic minorities. Legal immigrant children are excluded from participation in federal health care programs. Perhaps one of the most disturbing aspects of the rising number of uninsured Americans is that the vast majority of the uninsured are working individuals and their children. Kaiser Family Foundation found that in 2006, 147 million Americans were working and almost 28 million of those were not insured. Lack of health insurance now affects a diverse population of people from all income levels, racial groups, and employment types.

Additional Information

Report: American Families Face Harsh Reality: 2,000 Children Join the Ranks of Uninsured Each Day Georgetown University Health Policy Institute Center for Children and Families October 2007

Report: How Health Insurance Stability Impacts the Quality of Health Care Gerry Fairbrother, Ph.D. New America Foundation July 2005

Chapter 1: The Uninsured, Alliance for Health Reform

The Uninsured and Their Access to Health Care, Kaiser Commission on Medicaid and the Uninsured

The Costs of Being Uninsured

Two main “costs” are associated with the approximately 46 million Americans that currently lack health insurance. The first centers on the idea of a “health cost.” Inadequate access to proper health care, particularly preventative care, leads to increased suffering among the uninsured (and this suffering is particularly exacerbated when uninsured adults are three to four times more likely than insured adults to go without preventive services, such as screening for hypertension or breast cancer. When hospitalized, uninsured patients are likely to be in worse condition than insured patients, and the unisured are three times more likely to die in the hospital than insured patients. Every year, the deaths of 22,000 people between the ages of 25 and 64 can be attributed to a lack of health insurance. Researchers estimate that a reduction in mortality of 5 percent to 15 percent could be achieved if the uninsured were to gain continous health coverage.

The second “cost” is the economic price that all of society pays when millions of people are uninsured. For example, a study reported in Health Affairs says that people uninsured for any part of 2008 receive approximately $56 billion in uncompensated care while uninsured, and government programs finance about 75 percent of uncompensated care. The other 25 percent is paid by charging higher fees to the insured. Furthermore, Kaiser Family Foundation reports that the worker contribution ot employer-provided family coverage rose to about $3,350 in 2008, up more than 100 percent from 1999. A large part of this cost differential is due to the additional cost of delivering health care to the uninsured that is not paid for by the uninsured themselves or by other sources of reimbursement. Health care is a moral and economic issue and it is in everyone’s best interest to advocate for a system of health care for all.

According to Working America, one in four American say their family has had a problem paying for medical care during the past year — and two-thirds of them had insurance. Health care is a factor in half of all bankruptcies. A study by Kaiser Family Foundation shows that many workers with employer-provided coverage have had to pay a bigger share of health insurance premiums or higher copayments and deductibles. See the Costs page for more information.