LACK OF INSURANCE HARMING HEALTH, STUDY SAYS

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: FRIDAY, February 26, 1993                   TAG: 9302260153
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-3   EDITION: METRO 
SOURCE: Knight-Ridder/Tribune
DATELINE: WASHINGTON                                LENGTH: Medium
LACK OF INSURANCE HARMING HEALTH, STUDY SAYS
The medical insurance crisis has reached a level where it is blocking improvements in the overall health of Americans, the National Academy of Sciences warned Thursday in a bluntly worded study.
"Stagnation is the single best word to characterize our current state," said the report by the academy's Institute of Medicine. "Successes like improvements in breast cancer screening are counterbalanced by the return of diseases that can be avoided."
The study painted a demoralizing picture of a society split into insured and uninsured, increasingly vulnerable to tuberculosis, syphilis and other health scourges of generations past.
"Underlying most of the [trends] is a growing division between the haves and the have-nots in our society," the study said. Those who don't have coverage are going without care and getting sicker as a result, it said.
While much research has documented the rising number of uninsured, the study goes further by linking the gaps in coverage to a loss of momentum in dealing with the nation's pressing health problems.
The academy, an independent organization chartered by Congress to provide top-flight scientific advice, urged government to track problems in access to health care with the attention it devotes to measuring shifts in the economy.
It listed 15 indicators of access to health care, from use of prenatal care to the number of people receiving ongoing care for chronic illnesses, that could serve to track the effectiveness of health-care reform under President Clinton.
The indicators would work much like the unemployment rate, the inflation rate and other measures of the state of the economy.
Estimates are that Americans will spend $940 billion on health care this year - far more than residents of any other country. But the system of employment-based health insurance is leaving 37 million people without coverage at a time when costs have become prohibitive. Clinton has promised a reform plan to control costs and secure adequate coverage for all.
"Evidence is building that no or inadequate health coverage is the reason many . . . people fail to obtain the timely and appropriate care that would make a difference in the state of their health," the study said.
It estimated that as much as one-third to one-half of the gap between the death rates of middle-aged blacks and middle-aged whites could be due to the access problems faced by blacks. The death rate for middle-aged blacks is 75 percent higher than for their white counterparts. Overall, blacks are twice as likely to be uninsured.
Jack Hadley, a professor at Georgetown University in Washington who headed the panel that produced the study, said the problems with access to health coverage are a reflection of growing pressures on working people.
"The increase in the proportion of the population that does not have health insurance during the '80s and the slowdown or actual decline in family income are big factors," said Hadley. "Both are important determinants of whether people go to the doctor, and it's clear there's been a reversal in both."

by Archana Subramaniam by CNB