BOX 5-4The Institute of Medicine’s Uninsurance Series

• Coverage Matters: Insurance and Health Care (IOM, 2001e): The committee’s first report evaluated uninsurance in terms of subpopulations and demographics (e.g., age, gender, race, health status), as well as geographic distribution. The committee also considered differences between intermittent and long-term uninsurance.
• Care Without Coverage: Too Little, Too Late (IOM, 2002b): The second report evaluated research on the “effects of having or lacking health insurance on a variety of personal health-related outcomes” and offered criteria for reviewing the quality of available data related to insurance status and health outcomes.
• Health Insurance Is a Family Matter (IOM, 2002f): The third report assessed the effects of uninsurance on the health, financial, and psychosocial well-being and stability of families and children with an emphasis on childhood development.
• A Shared Destiny: Community Effects of Uninsurance (IOM, 2003l): The committee’s fourth report looked at the impact of uninsurance on communities and the interactions between uninsurance and factors related to local economies, public health, ethnic composition, and availability of health care resources.
• Hidden Costs, Value Lost: Uninsurance in America (IOM, 2003e): The fifth report explored the direct and indirect costs of uninsurance, estimating that annualized costs associated with uninsurance were between $65 and $130 billion due to diminished health and shorter life spans. The committee also described who bears these costs, from out-of-pocket payments covered by families to uncompensated care that is paid for by taxpayers.
• Insuring America’s Health: Principles and Recommendations (IOM, 2004e): The committee’s final report reviewed various insurance models, policies, and programs that could be used to expand health care coverage and eliminate consequences of uninsurance.