Uninsured climb to 46.6 million

The increase means more patients will delay needed care and be sicker when they do come in, doctors predict.

By Geri Aston, AMNews Staff. Sept. 18, 2006.

The number of uninsured Americans grew by 1.3 million last year, mainly due to the loss of employer-based coverage, new U.S. Census Bureau figures show. Physicians said the news exacerbates their frustrations over the human toll of the problem and the financial strain it places on their practices.

The 46.6 million people who lack coverage "don't access care in a timely manner," said AMA Trustee Ardis D. Hoven, MD, an internal medicine and infectious disease specialist in Lexington, Ky.

The first thing uninsured patients skimp on is preventive care, physicians said. "They think, 'I don't have insurance so I can't go to the doctor to get a Pap smear, a mammogram, a colonoscopy,' " Dr. Hoven said.

Mark Macumber, MD, sees the problem's impact every day. He doesn't accept insurance and charges a flat $40 fee for office visits. Virtually all of the patients at his two practices, one in Chicago and one in nearby Berwyn, Ill., lack health coverage.

"I see some very scary things," said Dr. Macumber, an assistant professor of family medicine at Northwestern University. "I see fractures, and people have taken care of it themselves."

Many uninsured patients are working poor, physicians said. They make too much to qualify for Medicaid but too little to afford insurance. Of the 37.8 million people of working age who lacked insurance in 2005, 27.3 million worked at some point that year, according to the Census Bureau figures, which approximate the number of people uninsured at some point in the year. The number of uninsured full-time workers grew from 20.5 million in 2004 to 21.5 million in 2005.