Caring for the Uninsured Choices for Reform

These recent events provide the impetus for this theme issue ofThe Journal: (1) Government reports show a 24% increase in the last decade in the total number of uninsured people and a 40% increase in the number of uninsured children.¹⁻⁴Most uninsured children are part of a family with a working adult. (2) Recent studies have found that, despite considerable amounts of uncompensated care provided by hospitals and physicians, Americans without health insurance face major barriers to the receipt of needed health services. Although they suffer from higher rates of ill health than the insured population, the uninsured report fewer hospitalizations and fewer visits to a physician, shorter hospital stays, and fewer discretionary inpatient hospital treatments and tests, at higher cost. The uninsured also experience higher mortality rates when hospitalized than persons with health insurance coverage who have similar medical diagnoses.⁵⁻¹¹(3) There is evidence of growing