1. A QUESTION OF ACCESS

2. WHAT ACCESS MEANS IN THE UNITED STATES

3. ACCESS IS RESTRICTED TO THOSE WHO HAVE HEALTH INSURANCE THROUGH THEIR EMPLOYERS
THOSE COVERED UNDER A GOVERNMENT HEALTH CARE PROGRAM.

4. THOSE WHO CAN AFFORD TO BUY INSURANCE OUT OF THEIR OWN PRIVATE FUNDS, AND
THOSE WHO ARE ABLE TO PAY FOR SERVICES PRIVATELY.

8. FLORIDA’S UNINSURED

9. FLORIDA HAS THE FOURTH LARGEST UNINSURED POULATION IN THE NATION

10. ALMOST ONE-FOURTH OF FLORIDA’S NON-ELDERLY POPULATION DOES NOT HAVE HEALTH INSURANCE COVERAGE

11. THE NUMBER IS EXPECTED TO CONTINUE TO INCREASE

12. IN 1997, 20% OF FLORIDA’S CHILDREN WERE UNINSURED

13. 43% OF FLORIDIANS AGES 21-24 DO NOT HAVE HEALTH INSURANCE

14. ETHNIC GROUPS WITHOUT HEALTH INSURANCE
HISPANIC – 32%
BLACKS – 31%
WHITES – 19%

15. EARLY RETIREES ARE A RAPIDLY GROWING GROUP OF UNINSURED FLORIDIANS
EARLY RETIREES ARE A RAPIDLY GROWING GROUP OF UNINSURED FLORIDIANS. FEWER EMPLOYERS ARE PROVIDING HEALTH BENEFITS FOR EARLY RETIREES.

16. 75% OF FLORIDA’S UNINSURED ARE EMPLOYED.

17. THE VAST MAJORITY OF EMPLOYERS ARE SMALL AND ARE LESS LIKELY TO PROVIDE HEALTH CARE INSURANCE.

18. WHY ARE PEOPLE LOSING HEALTH CARE INSURANCE?

19. WHEN HEALTH CARE COSTS RISE FASTER THAN WAGES THERE IS A DECREASE IN INSURANCE COVERAGE. LOW INCOME WORKERS CANNOT AFFORD TO BUY HEALTH CARE INSURANCE.

20. COST OF HEALTH INSURANCE PREMIUMS IS THE PRIMARY REASON PEOPLE DO NOT HAVE HEALTH INSURANCE COVERAGE. BECAUSE OF COST INCREASES, EMPLOYERS ARE SHIFTING MORE OF THE COST OF COVERAGE TO EMPLOYEES.

21. WHEN PREMIUM COSTS RISE, EMPLOYERS OF ALL SIZES ARE LIKELY TO SWITCH FROM CONVENTIONAL COVERAGE TO MANAGED CARE PLANS, RESTRICT HEALTH PLAN ELIGIBILITY (NO COVERAGE FOR PART-TIME OR TEMPORARY WORKERS), AND INCREASE COST-SHARING REQUIREMENTS.

22. SOME EMPLOYERS ARE ELIMINATING COVERAGE FOR DEPENDENTS OR SHIFTING THE ENTIRE COST TO THE EMPLOYEE.

23. MORE EMPLOYERS USE CONTRACT OR PART-TIME EMPLOYEES WHO ARE NOT ELIGIBLE FOR COVERAGE.

24. WELFARE REFORM IS MOVING PEOPLE OFF WELFARE AND INTO JOBS
WELFARE REFORM IS MOVING PEOPLE OFF WELFARE AND INTO JOBS. IN MANY CASES, THEY TEND TO MAKE TOO MUCH INCOME TO QUALIFY FOR MEDICARE. THE JOBS THEY TAKE DON’T ALWAYS OFFER INSURANCE.

25. IMPLICATIONS OF BEING UNINSURED

26. MOST PEOPLE WHO LACK HEALTH CARE COVERAGE RECEIVE LITTLE OR NO PREVENTATIVE CARE. THEY ARE LESS LIKELY TO FILL A PRESCRIPTION OR RETURN FOR FOLLOW UP CARE.

27. THE EMERGENCY ROOM BECOMES THE SOURCE OF PRIMARY CARE

28. HEALTH CONDITIONS THAT GO UNMANAGED CAN RESULT IN SERIOUS CONDITIONS REQUIRING HOSPITALIZATION.

29. EMERGENCY ROOM CARE REPRESENTS 7% OF ALL PATIENTS ADMITTED TO FLORIDA HOSPITALS.

30. IMPLICATIONS FOR THE FUTURE

31. THE 1998 STATE LEGISLATURE PASSED THE “FLORIDA KID CARE PROGRAM”
ENROLLING THEM REMAINS A CHALLENGE.

32. INCREASES IN HEALTH INSURANCE COSTS WILL RESULT IN MORE PEOPLE BEING UNABLE TO AFFORD COVERAGE.

33. HOSPITALS, FACING LOWER PAYMENTS FROM MEDICARE, MEDICAID AND MANAGED CARE COMPANIES, WILL STRUGGLE TO ABSORB THE COST OF CARING FOR THE UNINSURED.

34. PROGRAMS FOCUSING ON PRIMARY AND PREVENTATIVE CARE FOR THE UNINSURED POPULATIONS WILL BE THE KEY TO MANAGING THE COST OF CARING FOR THESE PATIENTS.

35. TAX INCENTIVES TO ENCOURAGE INDIVIDUALS WILL RESULT IN MORE AFFORDABLE COVERAGE.
SPECIAL FUNDING MUST BE AVAILABLE TO THE “SAFETY NET” HOSPITALS, I.E., THOSE HOSPITALS WHO SERVE A DISPROPORTIONATE AMOUNT OF UNINSURED PATIENTS.

36. Key Points to Remember
Most of the insured either work or come from a working family.
There is a higher incidence of un-insurance in the low-income, younger adults, and minority populations.
Most of the uninsured are U.S. citizens

37. Loss of health care delivery capacity
Less effective control of communicable diseases.
Losses to the community’s economic base.

38. Being uninsured effects the emotional health of individuals and families by:
Creating a fear of being denied health care or being bankrupt by illness
Forcing individuals to choose which medical services to utilize.

39. Internal Costs to individuals, families, and business firms
Greater morbidity and premature mortality
Developmental losses for children
Family financial uncertainty and stress, depletion of assets.

40. Lost income or uninsured breadwinner in ill health.
Workplace productivity losses (absenteeism, reduced efficiency on the job)
Diminished sense of social equality and self-respect.

41. End of Lecture for September 5th
2007, 6th Period
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