The rising number of uninsured Americans: how adequate is our health system?

A primary reason for the increase in uninsured Americans is due to the rising costs of health care that has caused a decline of employment‐based coverage for individuals working for small firms. According to the 1997 US Census Bureau figures, 43 percent of uninsured worked full‐time, and eight out of ten of the uninsured or their dependents were full‐time workers. While significant improvements at the state‐level have occurred to address the unmet health insurance needs of children, less emphasis has been placed on ways to improve access and utilization of health services for uninsured adults. This paper revisits where the health care debate has been over the last decade, system stresses currently being felt by providers in caring for the uninsured population, and the adequacy of the care which they receive. In addition, several incremental strategies for extending Medicaid coverage for children and their families, costs and financing projections, and implications for providers are examined.