A new black box warning has arrived on the U.S. health care scene: the lack of health insurance is hazardous to your health.

In 2004, the Institute of Medicine (IOM) recommended that Congress act to get the U.S. to universal health coverage by 2010. Today, the rate of uninsurance in the U.S. increases by the month as health costs continue to rise.

Thus, the IOM notes today in a new report, “there is no evidence to suggest that the trends driving loss of insurance coverage will reverse without concerted action.”

The Institute’s latest report into the nation’s state of health insurance, America’s Uninsured Crisis: Consequences for Health and Health Care, brings the 2004 recommendations into a new context of an economy in free-fall.

Back in 2004 the IOM’s Insuring America’s Health asserted that universal health coverage could improve health, economic productivity, financial security, and the health of communities’ health systems.

Today, public health is eroding, economic productivity is down, financial security is waning across all income groups, and hospitals’ bond ratings are plummeting.

In analyzing new sources of data published since the 2004 report, this latest IOM report finds the following:

1. Health insurance coverage is declining and will continue to do so.

2. The employer-sponsored health system is eroding and threatens expansions in public coverage (e.g., Medicaid).

3. Health insurance is integral to personal well-being and health. Safety net programs do not ensure optimal health.

4. High levels of uninsurance in a community can undermine health for the entire community’s public health.

Heatlh Populi’s Hot Points: The IOM’s latest report sets the table for health reform discussions this year. There’s one over-arching message here for those detractors of universal health coverage: it’s not about “them.” It’s about “us.”

The bottom-line finding after sifting through the plethora of five-years’ worth of evidence in the health literature is that, in communities where there are high levels of uninsurance, insured adults are more likely to have difficulties obtaining needed care.

There is an ecology in local health delivery systems: a balance of supply and demand, of financing and consumption of health resources.

Getting to universal coverage is the prescription for a healthier health economy, and the Economy writ large.

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