Census Bureau issues statistics, IOM challenges myths regarding uninsured - Institute of Medicine and Census Bureau issue reports about health insurance coverage - Brief Article

Healthcare Financial Management, Dec, 2001

The Census Bureau reported on September 28, 2001, that the number of Americans without health insurance actually declined from 39.3 million in 1999 to 38.7 million in 2000. An estimated 14 percent of the population had no health insurance coverage during all of 2000, down from 14.3 percent in 1999. Healthcare industry observers expect, however, that the number of people without insurance will increase in 2001 as a result of the economic downturn, increases in health insurance premiums, and layoffs triggered by the September 11 terrorist attacks.

The Census Bureau also reported that 29.5 percent of all poor Americans had no health insurance of any kind during 2000, compared with 31.1 percent in 1999. Among Americans overall, 64.1 percent were covered by a health plan related to employment for some or all of 2000, an increase of 0.6 percentage points over the previous year. Reflecting widespread Medicare coverage, 99.3 percent of people age 65 and older were insured. Young adults (18 to 24 years old) remained the least likely (72.7 percent) to have insurance in 2000. To view the Census Bureau's data, go to http://www.census.gov/hhes/www/hlthins.html.> Following the release of the Census Bureau's data, the Institute of Medicine (IOM) issued a report seeking to correct a number of "myths" that may hinder efforts to expand coverage to the uninsured. Contrary to the view that the uninsured somehow manage to obtain adequate care, the IOM finds that the uninsured are less likely than the general population to see a physician and receive preventive services. Further, the IOM cites increases in the cost of health insurance outpacing real income as a major barrier to acquiring coverage.

The IOM also expressed concern that hospitals lack sufficient funding to meet their obligation under the Emergency Medical Treatment and Active Labor Act to provide emergency care for the uninsured. Nonetheless, the IOM does not attribute the problem of overcrowded emergency departments to the uninsured, but rather to the declining number of hospital inpatient beds and the resulting inability of hospitals to transfer stabilized patients out of emergency departments.

The IOM report is the first of six reports that the IOM's Committee on Consequences of Uninsurance intends to release over the next two years. To read the report, go to http://www.iom.edu/iom/iomhome.nsf/WFiles/uninsuranceenglish/$file/ uninsuranceenglish.pdf.