ebook img

Health Insurance is a Family Matter (Insuring health) PDF

297 Pages·2002·4.93 MB·English
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview Health Insurance is a Family Matter (Insuring health)

Committee on the Consequences of Uninsurance Board on Health Care Services THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. Support for this project was provided by The Robert Wood Johnson Foundation. The views presented in this report are those of the Institute of Medicine Committee on the Consequences of Uninsurance and are not necessarily those of the funding agencies. International Standard Book Number 0-309-08518-7 Library of Congress Control Number 2002111131 Additional copies of this report are available for sale from the National Academies Press, 500 Fifth Street, N.W., Box 285, Washington, D.C. 20055. Call (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at www.iom.edu. Copyright 2002 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. “Knowing is not enough; we must apply. Willing is not enough; we must do.” —Goethe INSTITUTE OF MEDICINE Shaping the Future for Health The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the respon- sibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org COMMITTEE ON THE CONSEQUENCES OF UNINSURANCE MARY SUE COLEMAN (Co-chair), President, University of Michigan, Ann Arbor ARTHUR L. KELLERMANN (Co-chair), Professor and Chairman, Department of Emergency Medicine, Director, Center for Injury Control, Emory University School of Medicine, Atlanta, Georgia RONALD M. ANDERSEN, Wasserman Professor in Health Services, Chair, Department of Health Services, Professor of Sociology, University of California, Los Angeles, School of Public Health JOHN Z. AYANIAN, Associate Professor of Medicine and Health Care Policy, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts ROBERT J. BLENDON, Professor, Health Policy and Political Analysis, Department of Health Policy and Management, Harvard School of Public Health and Kennedy School of Government, Boston, Massachusetts SHEILA P. DAVIS, Associate Professor, The University of Mississippi Medical Center, School of Nursing, Jackson GEORGE C. EADS, Charles River Associates, Washington, D.C. SANDRA R. HERNÁNDEZ, Chief Executive Officer, San Francisco Foundation, California WILLARD G. MANNING, Professor, Department of Health Studies, The University of Chicago, Illinois JAMES J. MONGAN, President, Massachusetts General Hospital, Boston CHRISTOPHER QUERAM, Chief Executive Officer, Employer Health Care Alliance Cooperative, Madison, Wisconsin SHOSHANNA SOFAER, Robert P. Luciano Professor of Health Care Policy, School of Public Affairs, Baruch College, New York STEPHEN J. TREJO, Associate Professor of Economics, Department of Economics, University of Texas at Austin REED V. TUCKSON, Senior Vice President, Consumer Health and Medical Care Advancement, UnitedHealth Group, Minnetonka, Minnesota EDWARD H. WAGNER, Director, McColl Institute for Healthcare Innovation, Center for Health Studies (CHS), Group Health Cooperative, Seattle, Washington LAWRENCE WALLACK, Director, School of Community Health, College of Urban and Public Affairs, Portland State University, Oregon v IOM Staff Wilhelmine Miller, Project Co-director Dianne Miller Wolman, Project Co-director Lynne Page Snyder, Program Officer Tracy McKay, Research Associate Ryan Palugod, Senior Project Assistant Consultants Gerry Fairbrother, Research Director, Child Health Forum, New York Academy of Medicine Hanns Kuttner, Senior Research Associate, Economic Research Initiative on the Uninsured, University of Michigan vi Foreword Health Insurance Is a Family Matter is the third in a series of six reports planned by the Institute of Medicine (IOM) and its Committee on the Consequences of Uninsurance. This series of studies represents a major and sustained commitment by the IOM to contribute to the public debate about the problems associated with having more than 38 million uninsured people in the United States. This very broad research effort also represents a significant contribution from The Robert Wood Johnson Foundation for which we are grateful. Health Insurance Is a Family Matter adds to the IOM’s history of related contri- butions. Most relevant for this report on families is a consensus report issued by the Committee on Children, Health Insurance, and Access to Care in 1998, America’s Children: Health Insurance and Access to Care. That committee concluded that all children should have health insurance. Because this has not yet become a reality, the Committee on the Consequences of Uninsurance provides further evidence and confirmation of the effects on children of being uninsured, as well as the impact of uninsurance on the whole family. As we prepared to issue the Committee’s first report last fall, Coverage Matters: Insurance and Health Care, two hijacked airliners destroyed the World Trade Center and another severely damaged the Pentagon. After the initial shock and recovery began, attention turned to the families of the victims. Around the country people began asking what could be done for families who had lost their health insurance and their family’s income along with their loved ones. As the economy slowed and more people lost their jobs, the fear of becoming uninsured grew and Congress began debating what to do about the problem of health coverage interrupted by a job loss. These circumstances make this report on the family effects of being vii viii FOREWORD uninsured all the more important and relevant to current efforts to understand the problem and find solutions. The members of the Committee on the Consequences of Uninsurance are experts in a wide range of disciplines, including clinical medicine, epidemiology, health services research and delivery of services, economics, strategic planning, small business management, and health communications. They carefully consid- ered the pertinent evidence, and here present a coherent picture of the various effects that being uninsured has upon family well-being. This report shows that a family’s chance of having an uninsured member at some point is significant and that a lack of coverage can have negative effects on the uninsured child or pregnant woman. In addition, some of the ill effects of uninsurance spill over to other family members, even if they have coverage, and can jeopardize the family’s well-being and put the family unit at risk of financial disruption. Children are our nation’s future, and families are the place for raising and protecting them; it is crucial to the strength of the country that we consider the contribution health insurance makes to family well-being. This report will provide much material for reflection by policy experts, decision-makers, and the general public as they consider the various ways that being uninsured can erode the strength of America’s families—and what can be done about it. Harvey V. Fineberg, M.D., Ph.D. President, Institute of Medicine September 2002 Preface Health Insurance Is a Family Matter is the third report that the Institute of Medicine (IOM) Committee on the Consequences of Uninsurance is issuing since it began its research efforts in autumn 2000. Three more reports will be issued before the completion of the project in 2003. These reports represent the Committee’s efforts to review and assess the evidence concerning a wide range of causes and effects of being uninsured. The Committee is concerned with both the effects of lacking health insurance for individuals and the broader effects of having more than 38 million uninsured people in our nation. The Committee is following a carefully designed research plan so that each report builds on previous ones and provides a foundation for future reports. The first report, Coverage Matters: Insurance and Health Care, provides essential back- ground information for understanding the dynamics of health insurance, who is uninsured and why, and provides evidence to dispel many public misperceptions. Coverage does indeed matter. The second report, Care Without Coverage: Too Little, Too Late, presents an overwhelming body of evidence documenting the fact that adults without insurance suffer worse health. Now the third report widens the focus from the individual to the family. Health Insurance is a Family Matter analyzes the effects being uninsured can have on the health, finances and general well-being of the family. It also examines the health of uninsured children and pregnant women to see whether they also receive less care and suffer worse health outcomes than do those who are insured. The next report will expand the focus of attention even more to examine how having part of a community’s population uninsured can affect the community as a whole, including those with insurance. Then the Committee looks at the eco- nomic costs to society of sustaining an uninsured population of more than ix

See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.