The uninsured Featured

8:00pm EDT March 26, 2008

The U.S. health care system continues to lead the way in research and medical technology, discovering treatment breakthroughs that benefit Americans and people around the globe. It is not uncommon for individuals to travel to the U.S. to take advantage of our first-rate physicians, hospitals, drugs and treatments.

While our health care system is more sophisticated than most, our nation continues to struggle with the issue of the uninsured. According to the United States Census Bureau, there were 47 million uninsured Americans in 2006, a number that continues to grow, making one thing certain — the problem of the uninsured has reached critical mass.

“Access to health care is one of the most important issues facing the nation,” says Bill Berenson, senior vice president of Aetna’s Small and Middle Market Business for the North Central Region. “With the number of uninsured expected to increase, now is the time to take action against this growing problem; however, the onus should not rest with any one group. Transforming the U.S. health care system, including its financing, is a shared responsibility that requires public and private sector leadership and collaboration.”

Smart Business spoke with Berenson about the uninsured and the opportunities for employers, health plans, health care providers and government to work together to address this growing problem.

Who are the uninsured?

The uninsured are not a homogeneous group but, in fact, a diverse population composed of individuals from a wide range of ages, household incomes, professions and work statuses. Such diversity creates the need for different solutions for the various segments of the uninsured population.

What impact do the uninsured have on society?

The impact of the uninsured on society is enormous. Research shows that the uninsured generally obtain less care, use fewer preventive services and fail to adhere to recommended treatments. Because they do not receive early treatment and regular preventive care, treating the uninsured can be difficult, and the cost of care is significant.

When medical bills go unpaid, this cost is shifted to the government, medical professionals and the insured population. Tens of billions of dollars are spent each year treating those without health insurance, which places enormous strains on federal and state budgets, hampers the economy, and results in higher premiums for employers and those with insurance.

How can public and private sector collaboration solve the problem of the uninsured?

Addressing the problem of the uninsured requires public and private sector leadership and collaboration. A strong public-private partnership would allow the business community and employers to bring real-world experience in innovation and marketplace expertise to the table, while the government can encourage personal responsibility and create legislation that supports expanded access and the development of innovative marketplace solutions.

Because the uninsured are such a diverse group, a comprehensive variety of solutions — both public and private — are necessary to bring low-cost, high-quality health care to this growing population. Some common-sense approaches include:


  • Requiring all Americans to have health insurance coverage and pairing this individual coverage requirement with government assistance for low-income Americans who cannot afford coverage



  • Creating a legislative and regulatory environment that fosters the development and availability of affordable health insurance options



  • Using the tax system to expand access and increase affordability



  • Promoting greater portability of health insurance



  • Strengthening public programs to ensure that vulnerable populations have access to quality health care



  • Promoting preventive care and wellness


While the goal of expanding access to health care is clear, the path to achieving that goal is uncertain, which is why it is both important and necessary that government and the business community continue to work together to solve the problem of the uninsured. By working together, employers, health plans, health care providers and the government can forge solutions to build a stronger, healthier America.

BILL BERENSON is senior vice president of Aetna's Small and Middle Market Business for the North Central Region. Reach him at (312) 928-3323 or