Still 40 million uninsured: Why is there no progress?

AMA Leader Commentary. By Richard F. Corlin, MD. June 17, 2002.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from AMA President Richard F. Corlin, MD.

Louis T. Wright, MD, was a remarkable man. He graduated fourth in his class from Harvard Medical School in 1915 and was the first black doctor to obtain operating privileges on the staff of Harlem Hospital in the Bronx. He practiced there until his death in 1952.

As chair of the board of directors of the National Assn. for the Advancement of Colored People, Dr. Wright gave a great speech at the 1939 NAACP annual meeting in support of the principle that our country's health is no better than that of the most neglected health segment of our population. He said that there were 40 million uninsured people in this country, disproportionately aggregated among the Negro (an acceptable word to use in 1939) communities in the rural South and urban North, and that we must fight to end this situation.

Sixty-three years later, we still have that many uninsured in this country, disproportionately aggregated among all the minorities and the working poor, according to the recent Institute of Medicine report, "Care Without Coverage: Too Little, Too Late." Why haven't we made any progress in correcting this situation? We could probably list several reasons, but I would like to concentrate on one that gets very little attention.

In April, I gave a speech at the University of Iowa College of Medicine in Iowa City, in which I stated that we need a pragmatic approach to deal with the uninsured. I suggested that we put in place programs to help reduce the number from 40 million to about one-quarter to one-third of that number -- then accept that as the irreducible minimum for now and consider that a victory. We could then use that smaller number as a base to reduce even further in the future, using newer and different programs to meet that group's specific needs. [...]