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By Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance

"A Shared future" is the fourth in a chain of six experiences at the difficulties of uninsurance within the usa. This document examines how the standard, volume, and scope of neighborhood overall healthiness prone should be adversely tormented by having a wide or growing to be uninsured inhabitants. It explores the overlapping monetary and organizational foundation of wellbeing and fitness companies supply to uninsured and insured populations, the results of group uninsurance on entry to health and wellbeing care in the community, and the aptitude spillover results on a community's economic system and the health and wellbeing of its voters. The committee believes - it truly is either flawed and unsafe to imagine that the endurance of a large uninsured inhabitants within the usa harms in simple terms people who are uninsured.

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CONCEPTUALIZING COMMUNITY EFFECTS OF UNINSURANCE Although we often think of the impact of an injury in very personal terms, an injury to one may also be an injury to all. Consider the following examples. When a local hospital can no longer absorb the costs of serving uninsured patients in need of care and cuts back on staffed inpatient beds as a result, all members of the community served by the hospital are likely to experience reduced access to care. The effects do not stop there. In an effort to keep beds staffed, the hospital may contain costs by cutting staff in other departments, or, if the hospital cuts back its nursing staff, patient safety and the quality of care would be reduced for all patients.

1999. Rural Hospitals and the Local Economy: A Needed Extension and Refinement of Existing Empirical Research. Journal of Rural Health 15(2):189-201. , Ann Greiner, and Shari M. Erickson, eds. 2002. Fostering Rapid Advances in Health Care. Learning from System Demonstrations. Washington, DC: The National Academies Press. Cunningham, Peter. 2002. Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997-2001. Tracking Report No. 6. Results from the Community Tracking Study.

1 A conceptual framework for community effects. Health Care • Personal health practices • Utilization of health services • Processes of services delivery Process of Obtaining Access to Health Care 22 INTRODUCTION 23 surance, however, involve distinctly different policy issues, and the strategies for addressing them may differ. Throughout the Committee’s series of reports, the main focus is on persons with no health insurance and thus no assistance in paying for health care beyond what is available through charity and safety net arrangements.

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