The uninsured: A campaign for action

Late last month, the Census Bureau released a new round of numbers detailing a striking jump in the tally of the nation's uninsured.

These figures tell a stark story and the message behind them is clear: Now, more than ever, is the time to focus on this problem and make solving it a national imperative.

And what a problem it is. The Census Bureau, in its report, "Income, Poverty and Health Insurance Coverage in the United States: 2006," found the number of people without health insurance at some point in the year rose again, this time from 44.8 million (15.3%) in 2005 to 47 million (15.8%) in 2006. A key factor in the increase is the number who no longer have employer-provided or privately purchased health insurance. The percentage who received health benefits through an employer declined to 59.7% in 2006 from 60.2% in 2005. Moreover, the number of full-time workers without health coverage rose from 20.8 million to 22 million during that period, presumably because employers, workers or both found it cost prohibitive.

The nation also lost ground in what had been one of its few bright spots. For five years, the number of uninsured children in the U.S. decreased, mainly because of expansions in Medicaid and the success of the State Children's Health Insurance Program. For the second year in a row, however, this positive trend did not hold, and the number of uninsured children increased from 8 million (10.9%) in 2005 to 8.7 million (11.7%) in 2006.

Physicians know firsthand why these circumstances are dire. They see the difficulties every day -- the children with asthma who wind up in emergency departments, the patients with complications from untreated diabetes and the many others with equally troubling problems exacerbated by a lack of coverage. It is that essential missing element that is keeping millions of patients from seeking a physician's care before a problem becomes a crisis. That's why organized medicine is taking on the challenge of giving physicians and patients a voice in the process.

On the near horizon, Congress has returned to the task of hammering out a reauthorization of the expiring State Children's Health Insurance Program. The American Medical Association has been in the forefront of pressing for a result that will allow all the eligible kids who are uninsured to be covered.

But even a victory that allows more children access to health insurance is only part of what is truly necessary. Addressing the issue of the uninsured will involve a broad-based commitment. To this end, the AMA has launched a three-year, multimillion dollar campaign in conjunction with the election cycle. The first year focuses on efforts to talk with voters and candidates about the problem and the AMA's solutions.

Under the AMA plan, the majority of Americans would have the means to purchase health insurance through tax credits. People would have choices, so they can select the appropriate coverage for themselves and their families. And it would promote insurance market reforms.

The campaign's first phase will have a special emphasis in Washington, D.C., and early primary states. The objective will be to urge voters to cast their ballots with this issue in mind.

By the second year, 2008, the effort will go national. In 2009, the campaign's final year, the focus will shift to urging Congress to pass legislation to fix this national problem.

AMA leaders say the campaign is designed to raise the profile of the uninsured issue in the upcoming debate by empowering physicians to use their political might to do what they are trained to do -- look out for patients' best interests. For details, visit the campaign's Web site (link).

To achieve success, physicians, patients and lawmakers will have to step forward and be heard. After all, though these numbers are staggering, they mean so much more. Behind them are faces of men, women and children -- families -- for whom needed health care is a foregone hope because the cost of insurance is beyond their reach.