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. 2006 Sep 9;333(7567):516. doi: 10.1136/bmj.333.7567.516

More US citizens lack health insurance

Janice Tanne
PMCID: PMC1562468  PMID: 16960202

The number of US citizens without health insurance reached a record 46.6 million this year—an increase of 1.3 million on last year. This is according to the latest US Census Bureau’s survey (www.census.gov/cps).

Almost one in six US residents lacks health insurance. The number of uninsured people has increased by seven million since 2000.

Nearly all the new people without insurance were working adults aged 18 to 64, who might previously have had employer based insurance cover. The proportion of people covered by employer based plans, the most common form of insurance, fell from 59.8% to 59.5% of the population.

The percentage of US residents with any form of private coverage, through an employer or otherwise, also decreased. The percentage of US residents who bought private health insurance, which is usually more costly than insurance through an employer, decreased as well.

Middle income families, earning $35 000 to $50 000 (£26 000; €39 000), were increasingly affected. Almost half reported serious problems paying for health care and health insurance, found a study by the Commonwealth Fund, a non-profit making organisation that analyses healthcare issues. So did one third of families with incomes between $50 000 and $75 000 and 20% of families with incomes greater than $75 000.

The Washington Post reported that public health programmes covered more poor people, while more middle class people were now uninsured because health care had become more sophisticated and the costs of health insurance for small employers had become “prohibitively expensive” (www.washingtonpost.com, “Health care’s vicious cycle,” 31 Aug).

Medical costs have risen three times as fast as wages, so employers have tried to shift more of the health insurance costs to workers, the San Francisco Chronicle reported (www.sfgate.com, “More in US lack health insurance,” 30 Aug). A growing number of workers who are offered health insurance decline to take it because they can’t afford the higher costs.

The most disturbing thing was the number of children without health insurance, which has grown for the first time in years, said Diane Rowland, the executive vice president of the Kaiser Family Foundation and the executive director of the Kaiser Commission on Medicaid and the Uninsured, which are non-profit making organisations (www.washingtonpost.com, “DC suburbs top list of richest counties,” 30 Aug).

Several states have approached the problem with laws to move toward universal coverage.


Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

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