Ensuring Adequate Coverage For All

Ensuring adequate health insurance coverage for the 47 million people (and growing) without health insurance should be the number one priority.

Some will argue controlling costs is more important, but you can't get your hands around the cost problem until you get everyone into the system. It's like trying to fill a tub with water to measure how much it will hold when it has a leak in the bottom. Some will argue quality. However, a large reason for poor health outcomes is lack of coverage. Covering the uninsured takes a big step toward addressing both cost and quality while improving access.

In terms of reducing costs, we know that those with insurance pay an additional hidden "tax" of about $1,000 to help pay for the uninsured. The uninsured also receive care in the most inefficient and expensive ways, as I saw in my days as an emergency physician, often seeking care late in the course of illness or through hospital emergency departments. The Institute of Medicine noted that the uninsured cost our nation over $130 billion annually. Covering all will help reduce everyone's contribution to the uninsured's care.

About 18,000 people die prematurely annually because of lack of health insurance, and many more delay needed care because they are uninsured. Poor health outcomes and health disparities are the result. These are significant issues of quality that insurance coverage can help address.

Having an insurance card does not guarantee adequate access but it does get you in the door and will help address other problems that Congress needs to solve. These include increasing the number and distribution of primary care providers, reducing the financial problems that providers face that limit access, improving the clinical care management of chronically ill patients and optimizing emergency department utilization.

By Georges Benjamin  |  June 5, 2009; 3:18 PM ET  | Category:  Health Care Reform , Insurance
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