Oral

As the national debate over health care reform intensifies, it is important to review the problems reform is intended to address and to examine the effects of existing initiatives to improve access to care. This session presents three state-specific issues. From Kansas, the characteristics of low-income uninsured persons served by eight years of a local program are presented, documenting improvement in self-perceived health when access to care is provided. From Pennsylvania, state-wide surveys document improved coverage in response to state efforts to expand Medicaid, without the crowd-out of employer sponsored insurance that concerns some economists. From Alaska, a cautionary note is provided: in that state, low Medicare reimbursement rates are leading a majority of physicians to decline new Medicare patients. A national study of consumer perceptions identifies a topic that health care reform cannot directly address, the greater likelihood that minority adults will report difficulty in making appointments and obtaining healthcare. Finally, an analysis of the nationally representative linked mortality file reports the consequences of being uninsured in the present system: an increased likelihood of death.

Session Objectives: 1. Describe characteristic illnesses among uninsured persons who seek care. 2. Describe the effects of state-level efforts to improve insurance coverage and possible drawbacks when governmental programs have low reimbursement levels. 3. Describe the effects of lack of insurance on mortality.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)