NEWS

Entire Family Faces Consequences of Lack of Insurance, Report Finds

Charles Marwick

Families that lack health insurance risk not only their own health but also the health of the next generation, concluded a report from the Institute of Medicine (IOM) on the consequences of the uninsured.

Within weeks of the report’s release, the Census Bureau reported that the number of Americans without health insurance rose last year to 41.2 million, an increase of 1.4 million. Employment-based insurance coverage is threatened because of its increasing cost (premiums rose 13% this year), a rising unemployment rate, and the current economic downturn. What was particularly disturbing was that the increase in the uninsured was not limited to low-income families. The number of uninsured people with annual family incomes of $75,000 or more rose to 6.6 million in 2001, an increase of 811,000 over the previous year.

The two previous IOM reports (see News, July 3, p. 967) examined the effects of a lack of health insurance on the individual and reviewed its cause and extent in the United States. The latest report, "Health Insurance is a Family Matter," addressed the effect on the family. Families make decisions about seeking health care and deciding how much they can afford, the report pointed out.

"This report brings a new and different perspective on the family. If one member of the family is not covered for one reason or another, the entire family is vulnerable. The family is the basic unit in our society, both economically and socially," said Arthur L. Kellerman, M.D., Emory University School of Medicine, Atlanta, and co-chair of the committee that is preparing the reports. He spoke at a press conference announcing the report’s release.

The IOM report comes to four major conclusions, said Kellerman. An uneven employment-based and public insurance system leaves gaps in coverage; if a family has even one member uninsured for a year, the family often cannot afford major health expenses or is unable to purchase insurance, and the result is that family members avoid seeking care; Pregnant women, newborns, and children without health insurance have poorer access to care, receive fewer services, and hence often have poorer health outcomes; and children whose parents do not have health insurance are less likely to be insured even if they are eligible, making them less likely to receive care—often with long-term consequences.

Three other reports from the IOM will appear over the next year and are effectively laying the groundwork for yet another national debate on health insurance. A consortium of business leaders, the insurance industry, labor unions, and health care providers are already planning a series of events next spring to draw attention to the situation.

The full report is available on the IOM’s Web site at http://national-academies.org.



             
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