Abstract

This article defines the problem of the uninsured. It begins with an overview of why health insurance matters and presents a profile of the uninsured. It then discusses the roles and limits of private and public health insurance as sources of coverage for the nonelderly population. The article concludes with reflections on the current health insurance environment and prospects for reform.The large and growing number of uninsured people is of concern because health coverage makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately how healthy people are. About a quarter of uninsured adults say that they have postponed seeking care in the past year because of its cost, compared to about 6 percent of privately insured adults. In addition, more than half of uninsured adults have no usual source of care, compared to 1 in 10 adults with other types of coverage. Similarly, uninsured children are more likely to lack a usual source of care, delay care, or to have unmet medical needs than children with insurance. The uninsured are less likely to receive timely preventive and outpatient care and are more likely to be hospitalized for avoidable health problems. Improved access to care through health insurance ultimately has an impact on people’s health and lives: an estimated 22,000 excess deaths occurred among adults aged 25-64 in 2006 as a result of lack of health coverage.