In The News: August 5, 2003

New Upsurge In Uninsurance

Health Affairs authors calculate the cost of caring for and covering the uninsured

The U.S. Census Bureau recently announced an increase in the number of Americans without health insurance of 2.4 million, bringing the total to 43.6 million, or 15.2 percent of the population. Two Health Affairs authors have estimated how much treating the uninsured costs and how much it would cost the United States to cover them.

Using data from surveys of individuals, providers, and government programs, Jack Hadley and John Holahan estimate that uninsured Americans received $35 billion worth of uncompensated health care in 2001. Governments picked up $30.6 billion of the cost, while physicians' and hospitals' forgone time, profits, and philanthropy were responsible for between $7.5-$9.8 billion's worth of care for uninsured Americans.

In a second article, Hadley and Holahan project that it would cost between $33.9 billion and $68.7 billion to cover the uninsured. The lower cost would be under a government program, which would likely pay providers less, while the higher cost assumes the uninsured are enrolled in private-sector insurance plans that pay providers more.

Meanwhile, Kenneth Thorpe and David Howard show some of the consequences of being uninsured. The two authors show that health care spending for uninsured cancer patients was about 57 percent of that of insured cancer patients. They argue that extending health insurance to uninsured cancer patients "could result in earlier tratment and improved survival."

The September/October 2003 issue of Health Affairs is a special issue on mental health. David Mechanic writes that the prevalence of mental disorders is not necessarily a good measure of the need for mental health treatment. Haiden Huskamp writes that formularies may not work to control the costs of psychotropic drugs as well as they do to control costs in other drug classes. And Sherry Glied and Allison Evans Cuellar write that the mental health system still has many gaps when it comes to treating children and adolescents.

To see a listing of all the articles in the September/October Health Affairs, including the special mental health articles, see our table of contents. Abstracts and the full text of selected articles are available at no charge to nonsubscribers.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research.