THE UNINSURED

The number of uninsured Americans again increased in 2006 to over 47 million, the highest number in over a decade. The growing lack of health coverage has serious health and economic consequences for individuals and society. In fact, the Institute of Medicine (IOM) has estimated that the number of uninsured accounts for 18,000 unnecessary deaths each year and that 65 percent of the cost of health care for the uninsured is borne by the taxpayers through subsidies to hospitals and clinics.  Federal legislative efforts in 2007 centered on efforts to reauthorize and expand the State Children's Health Insurance Program (SCHIP) which resulted in an 18 month extension. The states continued to serve as “incubators” for health reform ideas with Indiana, Vermont, and, most notably, Massachusetts implementing reform proposals, and others such as California developing or debating plans. Policymakers can look at some of these state experiences as they unfold to determine approaches to emulate and to avoid.  The federal government should follow the lead of the states and move forward on legislation to increase the effectiveness of public health programs like SCHIP. In addition, by committing funds through refundable tax incentives, the government can allow maximum flexibility and help bridge the financial gap allowing consumers to buy the insurance that best fits their needs. At the outset of the 21st century when health care quality and innovation are at an all-time high, there has never been a better time or opportunity to solve the national crisis of the uninsured.