UTIVES the private sector-including both insurers and practitioners have so far looked to the government for solutions to this problem. Meanwhile, large employers believe that they have controlled the amount of cost shifting to them by negotiating lower premiums. As a result, their critical voice is not strong on this issue. It is possible to help meet this huge demand without sacrificing financial health. There are some operating models in existence being used by community clinics and other providers that might present alternatives for organizations to reincorporate care for these patients into their businesses. This is particularly true when states take innovative steps to further their role in this problem solving effort.Difficulties faced by the uninsuredAt a time of unparallel prosperity in the richest country in the world it is hard to believe that the U.S. is moving up in the ranks of the uninsured. To many Americans, the numbers are familiar - 44 million people without health insurance, or nearly 20 percent of the population under age 65. Eighty-five percent of them are working or in families were someone is working, mostly at low-wage jobs that offer no health coverage. Nearly one-third of the uninsured who work are offered coverage by their employer or through a family member's employer but decline it for themselves or their dependents because the price is so high - and getting higher. More than half of the uninsured have been without coverage for longer than two years (Consumer Reports Issue 9). More people are uninsured now than when President Clinton took office eight years ago promising health insurance for every American, and the long-term trend points north. Based on population growth alone, 47 million people will have no insurance five years from now (Consumer Reports Issue 9). This growth is at an alarming rate, especially when you take in to consideration that the uninsured usually receive what is considered second-...
