President's Message
The Best Health System
in the World

1. What's Wrong: A Snapshot
2. Lessons from the Scorecard
3. What's Right: A Blueprint for Change

Printable version of this article
(18 pages)

3. Access to Care
Access to care is a critical hallmark of health system performance. The single most important factor determining whether people can obtain essential health care is whether they have health insurance coverage. The scorecard looks at the percent of the population that is uninsured or underinsured, patient reports of difficulties obtaining needed care, and measures of affordability of insurance and care for families and employers. On these access indicators the U.S. scored 67 out of a possible 100.
Inadequate Insurance Coverage. In 2005, 46.6 million people were uninsured, 7 million more than in 2000. Because insurance coverage is very unstable and changes as people change jobs or life circumstances, 28 percent of working-age adults are uninsured at some point during the year. Cost pressures have also led employers to limit benefits and require higher deductibles and more cost-sharing by patients. As a result, at least 16 million insured adults are underinsured, and can experience financial difficulties obtaining care.
Rates of uninsured adults varied in 2004-2005 from 30 percent in Texas to 11 percent in Minnesota. By contrast nearly all major industrialized countries provide universal and comprehensive health insurance coverage.
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