What if your child risked dying from asthma because you couldn’t afford the doctor visits and medicines that could prevent a life-threatening attack? What if you had to choose between losing your house and paying up front for your spouse’s cancer treatments? What if you died from a heart attack because you were afraid that an unnecessary trip to the emergency room would leave you with a staggering bill you couldn’t pay?

Our nation’s failure to ensure that everyone has affordable health care has made such heartbreaking choices commonplace among the uninsured, who face devastating financial burdens when serious illness strikes.

Nearly 44 million Americans were uninsured during 2002, the Census Bureau estimates--almost a 6 percent increase over 2001. That’s more than 15 percent of the population.

And those numbers tell only part of the story. Millions more Americans are uninsured for short time periods or have skimpy coverage with low benefit limits or high deductibles. Lifetime benefit limits of $1 million or less are quickly exhausted when catastrophic illness or injury occurs. Minority-group members, young adults, and people with modest incomes are much more likely to be uninsured than others. The National Academies’ Institute of Medicine has reported that lack of insurance often means people simply do not get care for serious medical conditions. Uninsured women with breast cancer, for example, are 30 to 50 percent more likely to die from it than are insured women.

Today, proposals before Congress would close little gaps in the insurance void. But there is a lack of vision and leadership when it comes to forging a comprehensive solution to make health care affordable for everyone. This year’s congressional budget resolution sets aside $50 billion over 10 years to reduce the number of uninsured--barely one-tenth of what economists say is needed to make sure that everyone is covered. Yet by one estimate, tax cuts that were signed into law in 2003 could cost up to $100 billion a year. Tax cuts of that size make it nearly impossible to substantially expand health-care coverage to the uninsured.

This is not a new debate. Consumers Union first called for extending health-care coverage to all Americans in February 1939. Consumers Union Reports, our publication at the time, noted broad support for extending health-care coverage to all. The only question was how soon this goal of a "sensible and humane health program" would be accomplished.

During the ensuing six decades, we have supported various universal health-reform proposals. Most recently, after a failed effort by the Clinton administration in 1993 and 1994 to enact systemwide reform, we supported incremental steps to extend coverage to more people. For instance, we backed improvements such as extending coverage to parents of children on Medicaid and the State Children’s Health Insurance Program, and offering deep subsidies to those who lose their coverage because of unemployment. We have fought medical savings accounts, individual tax credits, and other proposals that are likely to increase premiums for the sick and undermine employer-based coverage, which spreads risk broadly among the healthy and the sick.

The time is ripe for a robust national debate on the uninsured. As more Americans are added to those rolls, and as even those who have insurance find gaps in coverage that impose financial burdens, it is hard to imagine an issue that could be more pressing to so many Americans and their families.

Lean on me

1983		2004

With America's waistline expanding, bathroom scales are getting a makeover. Body-fat scales, like those we tested recently, take weight-watching to a new level: They display weight and also estimate how much fat you're made of, usually based on your resistance to a trickle of electricity passed through the soles of your feet. But while that percentage may be more telling than body weight, the body-fat scales we tested were often inaccurate.