Covering the Uninsured

We are having lots of conversation, nationally and locally, about the cost of health care, and about the latest notion in health insurance, consumer-driven health care.

But we really must not forget the millions of our fellow citizens who are without health insurance of any kind, and who therefore don't have full access to our health care system. There are about 45 million people in America without health insurance and that census number likely understates the real magnitude of the problem.

We have a special mission here at UNC Health Care to serve those who have no other place to go and the uninsured are a large part of these most vulnerable North Carolinians. If we can make progress in our state with solving this problem, and many folks are working hard to do just that, it will have major impacts on our institution.

A few facts:

¢ 21 percent of adults and 12 percent of children are uninsured.

¢ 47 percent of the uninsured postponed care because of costs, compared to 15 percent of the insured.

¢ 37 percent of the uninsured did not fill a prescription because of cost, compared to 13 percent of the insured.

¢ The uninsured use less health care, are sicker when they access care, and have worse outcomes than the insured.

¢ Lack of insurance varies by region; North Carolina is in the group of states with an uninsurance rate higher than the national average.

¢ Lack of insurance varies substantially by race, with Hispanics most at risk for not having insurance.

¢ Almost 70 percent of the uninsured have at least one full-time worker in their household.

¢ Half of poor workers (less than 100 percent of the federal poverty level) are not offered insurance through their employer or their spouse's employer.

¢ At the same time, almost every state is needing to focus on cost containment for Medicaid, thus reducing the safety net.

The first week of May is Covering the Uninsured Week, led by the Robert Wood Johnson Foundation, of which I am a member of the board of trustees. There are a whole host of groups and individuals across the nation and around our state who will be participating in many activities to draw attention to this huge national problem and to build the public will to fix it.

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