title: The growing epidemic of uninsurance: new data on the health insurance coverage of Americans.
abstract: Despite a massive expansion of Medicaid and an upswing in the economy, the total number of Americans uninsured in 1993 was 39.7 million, more than at any time since the passage of Medicaid and Medicare in the 1960s. Since 1989, the ranks of the uninsured have swelled by 6.3 million. Millions more would be uninsured if Medicaid enrollment had not risen dramatically, by 10.5 million people since 1989. Loss of health coverage is a growing problem for middle-income families, women, and children, as it has long been for low-income families. Even in Hawaii, whose employer mandate program is often cited as a model of universal coverage, there was a large increase in uninsurance. Nationwide, the sharp upswing in the number of Americans who are uninsured has coincided with government and corporate policies to encourage medical competition and push people into managed care plans. Republican proposals to limit AFDC benefits threaten to further increase uninsurance, particularly among women and children. Only a Canadian-style single-payer reform can assure universal coverage and simultaneously contain costs.
authors.affiliation: Physicians for a National Health Program, Chicago, IL 60604, USA.
authors.forename: I
authors.initials: I
authors.lastname: Hellander
authors.forename: J
authors.initials: J
authors.lastname: Moloo
authors.forename: D U
authors.initials: DU
authors.lastname: Himmelstein
authors.forename: S
authors.initials: S
authors.lastname: Woolhandler
authors.forename: S M
authors.initials: SM
authors.lastname: Wolfe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000385:Aid to Families with Dependent Children / Q000191:economics / Q000639:trends; D002648:Child; D003363:Cost Control / Q000639:trends; D003625:Data Collection; D005260:Female; D005544:Forecasting; D018166:Health Care Reform / Q000191:economics / Q000639:trends; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000639:trends; D008484:Medicaid / Q000191:economics / Q000639:trends; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D006278:Medicare / Q000191:economics / Q000639:trends; D008875:Middle Aged; D009310:National Health Insurance, United States / Q000191:economics / Q000639:trends; D013221:State Health Plans / Q000191:economics / Q000639:trends; D014481:United States