New uninsured figures: A powerful reminder

The numbers are in: 46.6 million Americans were without health insurance in 2005 -- an increase of 1.3 million over the previous year, according to a report by the U.S. Census Bureau.

This reality is faced by 15.9% of Americans, including 8.3 million children. It represents a population more than five times that of New York City. This annual tally serves as a powerful reminder of the nation's reluctance to confront this growing problem and of the toll from that inaction.

Physicians experience its impact firsthand. They see the very sick patients who skipped needed medical treatment and preventive services because they had no insurance and who, statistics say, are more likely to die younger than their insured counterparts. Physicians also carry the financial burden -- costs estimated at an average of $2,000 a week -- that accompanies the uncompensated care they provide.

All of this is why the American Medical Association has long emphasized the need to treat the health system's ills.

The AMA has pressed for short-term measures to expand coverage for children and lower-income families and individuals. In the long term, the AMA has advocated for expanded coverage and choice through a system of refundable tax credits based on income, individually selected and owned health insurance, and market reforms that will enhance new, affordable insurance options.

At its Annual Meeting in June, the AMA added to this policy framework by introducing the concept of personal responsibility. This proposal would require those who earn more than 500% of the federal poverty level -- about 11% of the uninsured -- to obtain minimum catastrophic and preventive health coverage. Federal tax penalties would be used to achieve compliance.

But it is clear that sweeping solutions will take time. And uninsured patients need care today.

That's why the AMA also is a partner in programs such as the 2006 Covering Kids & Families Back-to-School Campaign, a Robert Wood Johnson Foundation initiative that aims to connect more parents and children with low-cost or free health care. Although eligibility varies, programs exist in every state and the District of Columbia that can cover doctor visits, hospital stays, prescriptions and more. The idea is to connect this coverage with uninsured families who need it.

Also taking an active role is the AMA Medical Student Section, which selected covering the uninsured and protecting access to care as its 2006-2008 National Service Project. During the next two years, students' work will be seen in a number of forms -- advocacy efforts and letter-writing campaigns aimed at policy-makers as well as AMA-MSS local chapter events dedicated to raising awareness and helping people take advantage of the resources available to them. Even Chapter Involvement Grants exist to help support these efforts.

The problem of the uninsured in America is tragic and complicated. Physicians are helping push the process forward to find an enduring answer. Until one is put into place, activism by physicians, both in their local communities and through the work of organized medicine, can make an enormous difference in the lives of patients. The efforts listed here are just a few examples of how physicians can help those who have been going without.