The Robert Wood Johnson Foundation is supporting a three-year study of the uninsured, which is being conducted by the Institute of Medicine (IOM). About one year ago a 16-member committee was appointed and charged with issuing six reports. The first such report, published in October 2001, was entitled “Coverage Matters: Insurance and Healthcare.” Their second report, published May 21, was “Care Without Coverage: Too Little, Too Late.” Ultimately, in their sixth and final report, expected in late summer 2003, the committee will present information about strategies and initiatives undertaken locally, statewide, or nationally to address problems associated with a lack of health insurance.
In their first report, the committee set out to debunk common myths about the uninsured with facts. The first such myth: The number of uninsured Americans isn’t particularly large and hasn’t increased in recent years. The committee estimated the number of uninsured exceeded the combined populations of Texas, Florida, and Connecticut—about 40 million people. The committee noted, “Despite a modest dip at the end of the 1990s and in 2000 following an extended period of economic growth and low unemployment, the number of uninsured has grown over the long term.”
A continued growth in the number of uninsured has certainly been the case here in the tri-county area. According to the Illinois Project for Local Assessment of Needs (IPLAN) in 1998, the most recent year for which they reported these statistics, both Peoria and Tazewell counties had 8.4 percent uninsured, and Woodford County had 10.7 percent. Although the State of Illinois initiated the Kid-Care program in 1998 to provide insurance coverage for children to age 18, because of the major welfare reform that same year, there was a significant increase in the number of people uninsured and even underinsured in the tri-county area compared to 1999. And, with the economic downturn in 2001, the number of uninsured increased even more in the tri-county area.
Another myth addressed by the IOM committee: Most people who lack health insurance are part of families in which no one works. In their initial report it was noted 80 percent of uninsured children and adults under age 65 live in working families, many of which include heads of families juggling several jobs to make ends meet.
The last myth tackled in the report: People without health insurance get the care they need. What they determined was people without coverage are less likely to see a doctor when they become ill or for treatment of a chronic condition. They estimated hospital emergency departments or outpatient units serve as the regular source of care for one of every six uninsured patients–almost 10,000 people in the tri-county area.
That last myth became the premise for the May report as the committee “examined the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks.” The committee reported “uninsured patients with colon or breast cancer face up to a 50 percent greater chance of dying than patients with private coverage.”
Many are concerned about this unfortunate situation, including the author of the comic strip, “Rex Morgan, M.D.” You may recall one of Rex’s patients he recommended have a colonoscopy died one year later from colon cancer because he was uninsured, the result of losing his job, and apparently couldn’t afford the procedure.
This committee is aggressively addressing the plight of the uninsured, who are having a major impact on health care in this country and specifically in the tri-county area. It will be interesting to see what recommendations the committee makes in its sixth report, so all of us in health care in the tri-county area can further address the needs of our uninsured residents. IBI
