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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 reviews at the difficulties of uninsurance within the usa. This document examines how the standard, volume, and scope of group future health providers might be adversely laid low with having a wide or transforming into uninsured inhabitants. It explores the overlapping monetary and organizational foundation of health and wellbeing prone supply to uninsured and insured populations, the consequences of neighborhood uninsurance on entry to health and wellbeing care in the neighborhood, and the aptitude spillover results on a community's financial system and the overall healthiness of its electorate. The committee believes - it truly is either unsuitable and hazardous to imagine that the patience of a large uninsured inhabitants within the usa harms purely those people who are uninsured.

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Journal of the American Medical Association 274(4):305311. Bitterman, Robert. 2002. Explaining the EMTALA Paradox. Annals of Emergency Medicine 40(5):470475. , Jill A. Marsteller, and Frank C. Ullman. 2000. Health Care for the Poor and Uninsured After a Public Hospital’s Closure or Conversion. Washington, DC: The Urban Institute. , Sandra H. Berry, Naihua Duan, Martin R. Frankel, et al. 1998. The Care of HIV-Infected Adults in the United States. The New England Journal of Medicine 339(26):18971904.

1999. Safety Net Hospitals: Essential Providers of Public Health and Specialty Services. New York: The Commonwealth Fund. , and Jack Needleman. 2002. The Impact of Uninsured Populations on the Availability of Hospital Services and Financial Status of Hospitals. Baltimore, MD: The Johns Hopkins Bloomberg School of Public Health. Hadley, Jack, and John Holahan. 2003. How Much Medical Care Do the Uninsured Use and Who Pays for It? Health Affairs Web Exclusive:1/W66-W81. Hartley, David, Lois Quam, and Nicole Lurie.

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.

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