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The imue is important because at the same time that policymakers are hceoniing incremingly

concerned ahoul thc numbers ol Americans svithuut hcatth insurance. snnie observers question whcthcr

providing more hcalth care hy improving linancial access necessarily leads tn better rare and iniprnvenicnts


indn idual health.



a hackgmund paper released inday, OTA reviews and etaluates the available literature nn the


rei-iew suycsts that uninsured Americans mavhe up tn thrce times nmre likclvthan


insurcd indiyirluals

to eaperienre a Inwer health ear: utilization ratc, pntentmllvinadcquate health care, and

lniliyidnals covered hy puhliclvelundcd

pmgrams such

as Medicaid rnayhc slightly better ol'! than

uninsured irnlii-nluals in the sence that they are rnere likely tn use health care scnices. and are hallas likely as

uninsured inrlii-nluals

to cxpcricnce pritentially inadequate mrc.

Uninsured Ameridans are l 3 times nmre

in rdcquate health services. and more than leur times mere likely tu experience an adverse health outcome.

OTA puints nin that, although the existing rcsearch dues nat allnw drawing a straight. uncomplicated

line from variatiens in insurance coverage tn patient hcalth rrutcnnies, the preponderance nf lindings srrnngly


that health insurance rnalscs a r.liHerence

There are, however, snnie studies that have lnund


ruxerage, access and health vary when different illnesses or medtml pmcedures are compared; iyhen


age. sea, nr racial groups arc scrutinized;

rir when specilh

hespitels are compared

Researchers in this lield

typically acknowledge that it is trni

early to rule edt alternative enplanatirms mr the Endings, whether rir not they

The literature review was requested by

the Scnatc Cnnrniittee on labor and Human Resources, as part

nfs broader UTA study on health insurancc

requested by that mmrntttee and endorsed by the Ranking

Minority Mernher nl the Hnuse Cnrnmittee rin Ways and Means Sulmrimmirtee en Health, the l-lmise

Conm-nttee on Energy and Commerce, and Senator Charles E. Grassley.

Copies nf the Vzepage background paper Dix: Health ImmrawmaMun ¤ Dulcvenceft for mngemihnal

tu: are available hy calling #*7141.

Cnpics for ncncnngrcsiuttal use can hc ordered lrnrn

the Superintendent nl'

Dtxunaents. U.S, Goverment Printing Office (GPO). Washingtnn. D.C. Zll·t0L

0249J2$; phone tml) 7K%-BIB.

The GPO stuck number is 052-0t`l3·l1D01

024l; the price is $5,00.

Sm. Edward M. Kznneiiv



Committee on Lalmrand Human Retutucer und Merrtbcn


'0TA's study- pruvides convincing evidence that comprehensive health refnmt k nut just it ques-tinn ol Gnancial prutectinn -- tt is a matter ol' lit': and death. Americans withnut health insurance receive lewer health

services and Irswer qualny care, and they sulfer peater illnes and death.

Far tnn often, illnesses that cnuld have

been cured hy

timely, Isnvecnst primary care lead tu emergency renin

treatment, hnspitaliuzion, or even dcath.


duuble standard ol health care in

nur snciety is unacceptable.


030s timely study is an important

new step nn the mad to making decent health ure a right and a reality for all our utizensf