An unprecedented 42 million Americans now have no medical insurance, “a foreboding increase” from 39 million just three years ago when President Clinton launched his ill-fated crusade for universal health coverage, according to an analysis released Friday by the American College of Physicians.
The study by the United States’ largest medical specialists group blamed the increase on the continuing decline in employer-provided coverage and on funding cuts for Medicaid, the $158 billion-a-year, federal-state health program for the needy.
The problem is not confined to the poor, the organization said. A third of the uninsured live in households with annual incomes of more than $30,300 - twice the federal poverty level for a family of four.
In their report, “Universal Coverage: Renewing the Call to Action,” leaders of the 89,000-member organization said the declining coverage was a moral and an economic issue and urged the presidential candidates and private industry to address it.
The group also called for a public debate to explore alternatives to the nation’s employer-based health insurance system, which came of age after World War II but has been steadily shrinking in recent years as businesses retrench in the face of steep medical inflation.
The report, released in San Francisco at the American College of Physicians’ annual meeting, could hardly be more timely. It comes at the start of the presidential campaign season, barely 18 months after Clinton’s massive agenda to overhaul the $1 trillion-a-year health care system collapsed and only a few months after Congress failed in its attempt to restructure Medicare, the $178 billion-a-year health program for the nation’s 37 million elderly.
And now Congress is bogged down in partisan wrangling over an insurance reform bill that seeks to provide security to those already insured by making it easier for them to stay covered even after developing a serious illness or leaving a job.
That legislation would be “a first step” toward reversing the rising tide of uninsured, said the American College of Physicians, whose members are internists who provide the bulk of adult care in the United States.
This sidebar appeared with the story: UNINSURED AT RISK The study, conducted by the Urban Institute, also concluded: Lack of insurance is associated with a 25 percent higher risk of death. This finding was based on a 16-year study of 700 uninsured persons. Had they all been covered by insurance, 25 of the 128 persons who died would still be alive. Uninsured children who are injured were only 73 percent as likely as insured children to receive treatment. In addition to the 42 million uninsured Americans, another 29 million (or 18.5 percent of those under age 65) are underinsured, meaning that they could not afford out-of-pocket medical costs that exceed 10 percent of family income.