Title: National Health Policy Conference AcademyHealth
1National Health Policy Conference
AcademyHealth Health Affairs
- Panel on Consequences of Uninsurance January 28,
2004
2IOM Committee on the Consequences of Uninsurance
- Task
- Assess / consolidate evidence about the health,
economic and social consequences of uninsurance. - Raise awareness and improve understanding by both
the general public and policy makers. - 6 reports between Fall 2001 and Jan. 2004
3Series Insuring Health
- Coverage Matters (Oct 2001) presented an overview
of insurance and health care. - Care Without Coverage (May 2002) documented the
health impacts for adults of lacking coverage. - Health Insurance Is a Family Matter (September
2002) identified health and financial
consequences of the lack of coverage for families.
4Series Insuring Health (cont.)
- 4. A Shared Destiny (March 2003) traced the
effects of uninsured populations on communities
health services and economic and social vitality. - Hidden Costs, Value Lost (June 2003) explores the
economic and social effects of uninsurance at the
national level. - Insuring Americas Health (January 2004) calls
for action and sets principles to guide and
inform the development of policy solutions.
51. Coverage Matters
- 80 of uninsured live in working families
- Two-thirds live in families earning less than 200
of FPL - Most often not a choice health insurance is
unaffordable for most of uninsured - More than 70 million lack coverage at some point
over 3 year period
6Care Without Coverage Too Little, Too Late
- Uninsured adults
- Receive fewer, less timely preventive services
- Less likely to receive appropriate care for
chronic illness, and have worse outcomes - Receive poorer hospital-based care
- Cancer patients in poorer health, more likely to
die prematurely
7Care Without Coverage Too Little, Too Late
(cont.)
- Continuity of coverage matters
- Overall, uninsured have a higher risk of dying
- About 18,000 excess deaths in 2000
- among uninsured age 25-64
83. Health Insurance is a Family Matter
- One uninsured member impacts entire family
- About 60 million in families with at least one
member uninsured - Children in uninsured families receive fewer
services - Children in families with an uninsured parent
less likely to receive appropriate care whether
or not the child is uninsured.
94. A Shared Destiny Community Effects of
Uninsurance
- A communitys high uninsured rate can adversely
affect its health care institutions and
providers, reducing access to services - The capacity of clinics and community health
centers to serve their clientele, including those
with coverage, is strained by large numbers of
uninsured patients.
104. A Shared Destiny Community Effects of
Uninsurance (cont.)
- EMS, trauma care, specialty referrals, services
for vulnerable populations are less available - Rural hospitals have lower financial margins,
fewer ICU beds, less likely to offer high-tech
services - The financial instability of health care
institutions and providers can hurt local
economies.
115. Hidden Costs, Value Lost
- Most of costs of uninsurance are not health care
costs - Greatest economic losses come from worse health,
shorter lives - Estimated annual economic value of foregone
health for 40 million uninsured is between 65
billion and 130 billion.
125. Hidden Costs, Value Lost (cont.)
- Cost of health services for those uninsured for
any part of a year is about 99 billion (2001) - Incremental cost of additional services is
34-69 billion (2001) - About half of annual increment in spending from
2000 - 2001
13The value of health capital forgone each year due
to uninsurance is estimated between 65 and 130
billion
18,000 die prematurely.
Uninsured children / adults receive fewer and
less timely services.
8 million uninsured with chronic illnesses
receive fewer services and have increased
morbidity and worse outcomes.
41 million uninsured are less likely to receive
preventive and screening services.
60 million uninsured individuals and their family
members have less financial security and
increased life stress due to lack of insurance.
People in communities with a higher uninsured
rate are at risk for reduced availability of
health care services and overtaxed public health
resources.
All Americans