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Uninsured Priority Paper
Problem: The number of uninsured persons continues to grow
throughout the nation. Research has shown that uninsured people
delay necessary care and are in poorer health than their insured
counterparts.
Recommended Action: To address the issue of the uninsured,
policymakers must go beyond Medicaid and Medicare reform and look
at the entire health care system. As a country, we must recognize
that the current system leaves too many people behind and should
evaluate the true cost of health care coverage for all.
On September 30, 2003, the US Census Bureau confirmed what the
Federally Qualified Health Centers (FQHC) and FQHC 'look alikes'
have been suspecting. The numbers of uninsured are growing in Michigan
and across the country. Michigan is one of eighteen states who saw
the proportion of their population without health insurance coverage
increase from 2000-2001 to 2001-2002. In fact, only five states
saw more significant decreases in coverage. The Kaiser Commission
on Medicaid and the Uninsured's report "The Cost of Not Covering
the Uninsured - Project Highlights" dated June 2003 included
the following points in its key findings:
- The uninsured receive less preventive care, are diagnosed at
more advanced disease stages, and once diagnosed, tend to receive
less therapeutic care and have higher mortality rates.
- A conservative estimate based on the full range of studies is
that a reduction in mortality of 5-15% could be expected if the
uninsured were to gain continuous health coverage.
- Better health would improve annual earnings by about 10-30 percent
and would increase educational attainment.
- On average, the uninsured receive about half as much care as
people who are insured all year. In 2001, persons uninsured for
the full year used $1,253 per year in medical care compared to
$2,484 for persons with private coverage for the full year.
- Total uncompensated care provided in 2001 was estimated to be
$35 billion dollars. The primary source of funding for uncompensated
care is government, which spent an estimated $30.6 billion for
care of the uninsured, two thirds of which is federal.
- The overall impact of coverage for all persons on total health
care costs would be an increase of 3-6% in total health care spending
in the U.S., less than the annual inflation in health care spending
(8.7% in 2001) in the current health care system.
Reforming Medicaid and Medicare, while helpful for increasing coverage
for certain populations, cannot stand alone as the answer to the
problem. Many people, including policymakers, forget that Medicaid
is a categorical program. Simply being poor is not enough to qualify.
A person must also be blind, aged, disabled, pregnant, a child,
or a caretaker of a child on Medicaid. Similarly, a person must
be over 65 or disabled to qualify for Medicare. To truly address
the issue of the uninsured, policymakers must begin to reevaluate
the entire health care system supported so heavily by public funds
rather than the piecemeal approach that has brought us to the current
structure.
For over 30 years, Michigan's community, migrant, HIV/AIDs and
homeless health care programs have been delivering comprehensive
primary care to the medically underserved communities in our state.
Michigan's 26 Federally Qualified Health Center (FQHC) and FQHC
'look-alike' organizations form an essential component of the state's
safety net for health care services and provide a comprehensive
set of health care services at almost 100 different locations. These
organizations are on the front lines of health care serving the
most vulnerable populations, including rural and inner city communities
lacking adequate providers, patients on Medicaid, the low-income
uninsured, the underinsured (working poor), and persons living on
the edges of these groups. FQHCs are committed to providing high
quality, comprehensive health care services to federally designated
medically underserved areas/populations.
For these reasons, we are requesting your support. For more
information, please contact:
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