The state of the health care system of the US has always been a subject of great controversy. The recent approval of the Children´s Health Insurance Bill by President Obama which gives health care access to all American children as well as children of legal immigrants was met with mixed reactions. Its proponents were pleased and hope that this is the first step in their goal of having health coverage for everyone. Those against the bill, on the other hand, the bill too closely resembles “socialized medicine” or “government-run health care for every one” that can easily be abused and can cost taxpayers a lot of money.
A recent report by the Institute of Medicine (IOM) states that “having health insurance is essential for people’s health and well-being”. However, the report continues to provide troubling statistics about health insurance coverage in the US, namely:
- The number of people who have health insurance is decreasing.
- Employment-sponsored coverage, which is the main source of insurance coverage for Americans, is also dropping due to increasing unemployment and the current economic crisis.
- In 2007, almost 10% of American children and 20% of non-elderly adults had no health insurance.
- In a separate report by the U.S. Department of Health & Human Services (HHS) the number of children enrolled in the State Children’s Health Insurance Program (SCHIP) has increased by 4% in 2008, probably due to the current economic crisis.
The IOM report states that there is an urgent need for government intervention to prevent further decline of health insurance coverage among Americans.
The report gives evidence that the problems of the uninsured can spill over to the whole community whereas coverage for everyone benefits everyone, not only the needy. This was demonstrated by comparing the health status of people before and after enrolment in Medicare, Medicaid, and the SCHIP.
What are the consequences of lack of insurance coverage?
- Adults without coverage are much less likely to receive preventive and preemptive care that can reduce preventable diseases and premature death.
- Thise with underlying and chronic conditions delay or forgo check ups and are less likely to comply with follow-up treatments.
- Early screening and detection are less likely among the uninsured whereas diagnosis of late-stage cancers and acute conditions are more likely.
- Those hospitalized with serious conditions are also more likely to suffer poorer outcomes and premature death, and have poorer quality of life.
These problems can affect those with health insurance as well.
Based on the available evidence, the committee concluded that when a community has a high rate of uninsurance, the financial impact on health care providers may be large enough to affect the availability, quality, and cost of local services for everyone, even people who have insurance. For example, survey data show that privately insured, working-age adults in areas with higher uninsurance rates are less likely to report having a place to go for care when sick, getting a checkup or routine preventive care, and seeing a specialist when needed. They are also less likely to be satisfied with their choice of physicians or to trust their doctors’ decisions.
However, there is also evidence obtaining coverage lessens or reverses many of these harmful effects. As an example, insurance coverage for children can have the following benefits:
“Children are more likely to gain access to a regular source of care, immunizations and checkups, needed medications, asthma treatment, and basic dental services. Serious childhood health problems are more likely to be identified early, and those with special needs are more likely to have access to specialists. Insured children experience fewer hospitalizations and improved asthma outcomes, and they miss fewer days of school.” In the process, outbreaks of infectious diseases and disruption of school schedules are reduced.
Currently, Americans without health insurance coverage are taken care of by the so-called “safety-net services such as charity care and emergency departments.” The IOM report, however, indicates that these “safety nets” are not enough and is urging the current US administration to act urgently and solve the “crisis of the uninsured.”