Uninsured Persons

The number of Americans without health insurance has been increasing by 1 million per year. In 2008 the number of uninsured persons was 46 million, or 16% of the U.S. population. The number of people who are underinsured (another 50 million) is growing even more rapidly. Contrary to widespread belief, the problem is not confined simply to unemployed or poor persons. More than one half of uninsured persons have annual incomes greater than $75,000, and 8 of 10 are in working families.

The United States is the only developed country that does not have universal health care coverage for all its citizens. According to Geyman, "Today's nonsystem is in chaos. A large part of health care has been taken over by for-profit corporations whose interests are motivated more by return on investment to shareholders than by quality of care for patients" (2002, p. 407).

The Institute of Medicine (IOM) report on the uninsured population, Insuring America's Health: Principles and Recommendations, called for "health care coverage by 2010

that is universal, continuous, affordable, sustainable, and enhancing of high-quality care that is effective, efficient, safe, timely, patient centered, and equitable. . . . While stopping short of advocating a specific approach, the IOM's Committee on the Consequences of Uninsurance acknowledges that the single payer model is the most effective in ensuring continuous universal coverage that would remain affordable for individuals and for society" (Geyman, 2004, p. 635).

Family physicians account for a larger proportion of office visits to U.S. physicians than any other specialty. However, Geyman (2004) observed problems:

The country's health care (non) system has undergone a major transformation to a market-based system largely dominated by corporate interests and a business ethic. The goal envisioned in the 1960s of rebuilding the U.S. health care system on a generalist base, with all Americans having ready access to comprehensive health care through a personal physician, has not been achieved. Overspecialization was a problem as long as 4000 years ago, when Herodotus in 2000 bc noted that "The art of medicine is thus divided: each physician applies himself to one disease only and not more."

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