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At least 19 recordsLinked to original sources
PubMed1989

A profile of the medically uninsured in Georgia.

The provision of health care to the growing number of persons uninsured against medical expenses affects Georgia doctors, hospitals, and state and local government at all levels. While much is known nationally about the uninsured, there are no good data about this group in Georgia. This study uses U.S. Census Bureau data to provide a demographic profile of Georgians who lack health insurance and to identify groups at particular risk for being uninsured. Approximately 950,000 (17.7%) of non-elderly Georgia residents are uninsured, compared to 37 million (17.6%) in the U.S. as a whole. As is true generally in the U.S., those in Georgia who are poor, young, non-white, and in families with a female head are at greatest risk. Of particular note are the poor in Georgia with incomes from 50% to 100% of the federal poverty level (55.2% uninsured). This population deserves the special attention of all involved in finding a solution to this problem.

Employment↗
PubMedDate not supplied

Utilization of medication-assistance programs for medically uninsured patients: one public teaching hospital's experience.

Although many pharmaceutical companies have programs that provide prescription medications to medically uninsured or underinsured patients, many health-care providers have not taken full advantage of the programs for a variety of reasons. In an effort to offset the escalating costs of medications for this group of patients, one public teaching facility developed a program to better utilize pharmaceutical patient-assistance programs. Resources are described, including Web sites and available publications, that may improve utilization of assistance programs. Eligibility criteria and enrollment procedures for specific drug reimbursement programs are included. Enrollment of medically underinsured or uninsured patients into medication-assistance programs can produce significant savings that benefit patients and institutions. Healthcare providers must examine all avenues to provide medications to the medically uninsured.

California↗
PubMed2000

Living on the edge: a phenomenological study of medically uninsured working Americans.

An estimated 35 to 50 million Americans have no medical insurance; the vast majority are employed persons and their dependents. This phenomenological study was developed to make visible the experience of working Americans living on the edge-forced to walk a fine line between health and illness without the safety net of medical insurance. A purposive sample of 12 individuals was asked, "What is it like to be working and without medical insurance? Based on textual analysis, using an adaptation of Colazzi's method, themes were grouped into four theme clusters: A Marginalized Life, Up Against Rocks and Hard Places, Making Choices-Chancing It, and Getting By-More or Less. These are illustrated through commentary and direct quotation to depict an overall sense of the experience. Implications for nurses charged with addressing the needs of the medically uninsured and for nursing as a whole are discussed.

Adult↗
PubMedDate not supplied

Who are the medically uninsured in the United States?

The Employee Benefit Research Institute (EBRI) analysis of the March 1993 Current Population Survey revealed that 38.9 million Americans had no private or public health insurance during 1992. This number was up some 2.3 million over that for 1991, an increase larger than was experienced from 1989 through 1991. The proportion of the total population without such insurance also steadily increased, rising from 14.3 percent in 1989 to 15.4 percent in 1992. In 1992, 38.5 million nonelderly Americans, or 17.4 percent of those under age 65, had no health insurance, up 4.1 million since 1989. A primary reason for the rising number of the nonelderly uninsureds was a decline in health coverage among individuals (and their families) working for small firms. Among the total U.S. population, close to 59 percent received employment-based coverage. Of the remainder, Medicare accounted for just over 13 percent of the coverage, Medicaid for just over 11 percent and individually purchased private sources other than an employer or union for almost 12 percent. The New England region had the lowest proportion of medically uninsureds (almost 12 percent) and the West South Central the highest (over 25 percent). By state, Hawaii and Connecticut reported the lowest percentage of medically uninsureds, whereas Nevada, Oklahoma, Louisiana and Texas reported the highest proportions in 1992.

Adolescent↗
PubMed1990

The medically uninsured: problems, policies, and politics.

The ranks of the medically uninsured have grown significantly in recent years, but no consensus on a policy solution has emerged. After summarizing the characteristics of the uninsured population, this paper reviews diverse policy responses and their troubled political prospects.

Federal Government↗
PubMed2004

Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

BACKGROUND: Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. OBJECTIVES: This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. RESEARCH DESIGN: The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. RESULTS: At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. CONCLUSIONS: Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

Adolescent↗
PubMed1998

Managed care for the medically uninsured: the preliminary experience of CU CARE.

Uninsured Americans often face barriers to or lack continuity of care. Care for this population is often fragmented, expensive and undercompensated. University Hospital in Denver, in partnership with Kaiser Permanente of Colorado, sought to address this problem by developing CU CARE, a managed care demonstration program for the medically uninsured within the University of Colorado Health Sciences Center. This paper describes the evolution and preliminary experience of the CU CARE program. Policy implications for the future of health care delivery to this population are also briefly discussed.

Colorado↗
PubMed1990

Medically uninsured children in the United States: a challenge to public policy.

This article is an examination of the nature and extent of the problem presented by medically uninsured children in the United States. First, the characteristics of the uninsured population are explored with a description of how age, family income, and employment status disproportionately affect families with children. Second, the Medicaid program and its historically inadequate response to this growing problem of uninsured children is examined. Third, the relationship between insurance status and the health and development of children is discussed. Finally, recent public policy initiatives that have been enacted or proposed to address this inequity in the present health care system are reviewed with a recommendation to establish a "Universal Maternal and Child Health Program."

Adolescent↗
PubMed1990

Medically uninsured children in the United States: a challenge to public policy.

This article is an examination of the nature and extent of the problem presented by medically uninsured children in the United States. First, the characteristics of the uninsured population are explored with a description of how age, family income, and employment status disproportionately affect families with children. Second, the Medicaid program and its historically inadequate response to this growing problem of uninsured children is examined. Third, the relationship between insurance status and the health and development of children is discussed. Finally, recent public policy initiatives that have been enacted or proposed to address this inequity in the present health care system are reviewed with a recommendation to establish a "Universal Maternal and Child Health Program."

Adolescent↗
PubMed1991

Politics and equity in policy-making for the medically uninsured.

A sizable number of Americans (many of low income) lack health insurance, and their ranks grew over the 1980s. One might expect to find vigorous political efforts to redress this inequity. In fact, conflicting normative and practical images of equity have blunted the sense of urgency of the problem, inhibited agreement on the proper division of labor between the market and government, and blocked consensus on strategic models for public policy for the uninsured.

Health Policy↗
PubMed1995

UCHP: a case study of access for the medically uninsured.

Utah Community Health Plan (UCHP) is one of fifteen Robert Wood Johnson Foundation Programs for the uninsured. The experience of UCHP is similar to the other nine demonstration programs for the uninsured who have actually enrolled individuals: offering premium subsidies to uninsured small employers is an ineffective way to expand coverage among the working uninsured.

Community Health Centers↗
PubMed1991

Pennsylvania's medically uninsured population: findings from a statewide survey.

Pennsylvania is currently considering legislative options to expand coverage and improve access to medical care for state residents who lack health insurance. Relevant data are presented from a telephone survey of 10,809 Pennsylvania households. Almost nine percent (8.5%) of the state's population lacks health insurance, representing over one million people. Those most likely to be uninsured are children and young adults, non-whites and the poor. A substantial number of poor people are not covered by the state's Medicaid program. The uninsured report poorer health status, more obstacled to receiving care and greater use of hospital services for primary care.

Adolescent↗