Column: Economic and social costs of ignoring the uninsured

Much attention has been devoted to the ability of our public health system to respond and react to emergencies such as bio-terrorist attacks. While such attacks are growing threats to our society, they are by no means the only threat. The silent and very serious crisis that endures in this country is the ever-growing numbers of uninsured, which has been increasing continuously for the past 16 years.

The uninsured represent nearly 15 percent of the population in the United States and nearly a quarter of them are children. While two-thirds of the uninsured are low-income, more than 80 percent of the uninsured come from working families, 72 percent of which come from families with one or more full-time worker and 12 percent come from a part-time working household member. Low-wage workers, laborers, service workers and those employed in small businesses are at greater risk of being uninsured.

The economic cost of uninsured people in the United States is enormous. According to the latest Kaiser Commission on Medicaid and the Uninsured Report (KCMR), in 2001, the government spent $35 billion providing health care to more than 40 million uninsured Americans. The KCMR reports that 44 percent of the uninsured had trouble paying medical bills and over a third had been contacted by a collection agency.

Clearly, the costs of paying for the medical condition of one family member can drain the financial resources of the entire family, some of which would have gone toward health related services. With the economy continuing to weaken, the cost of health care continues to increase, along with the number of people unable to cover the cost of health services.

As great as the economic costs are, the human costs are even greater. In an effort to conserve financial resources, the uninsured are at least three to four times more likely than the insured to seek medical care, even for serious conditions. They are less likely to receive regular checkups and, therefore, are more often hospitalized for conditions that could have been prevented. They are also diagnosed at later stages of disease, such as cancer, when symptoms become unmanageable and treatment options become more limited. The uninsured often receive less effective drugs and undergo fewer surgeries. In short, they are becoming needlessly sicker.

Perhaps our lack of attention to the uninsured is an unfortunate product of our individualism. We must not fail to remember that a person with an illness is more than just an individual. He or she is also a member of a family, a community and a nation. This issue reaches far beyond an economic perspective. It is an issue of equity, equality and social justice.

In an effort to make the public more aware about the plight of the uninsured, the Robert Wood Johnson Foundation initiated “Cover the Uninsured Week.” Beginning on March 10 and ending on March 16, the week will consist of a series of events and activities designed to educate and inform the public.

On Tuesday, March 11, GW’s Health Advocacy Initiative and Department of Health Policy will host a lunch event with speakers focusing on the present crisis and potential directions for the future. These speakers include Chris Jennings, former Health Advisor for Bill Clinton and Gail Wilensky, former Health Advisor for George Bush Sr. The event will take place in the Marvin Center Continental Ballroom from 12:00 to 1:30 p.m.

For further information e-mail Kimberly Switlick at

-The writers are graduate students in the School of Public Health

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