Author Affiliations: University of Virginia School of Medicine, Charlottesville (Dr Garson); and Harvard Medical School, Boston, Mass (Dr Blumenthal).
By 2013, the number of uninsured individuals in the United States is projected to be 56 million, approximately 1 in 5 US residents.1 Because uninsured individuals have a 25% higher mortality than those who are insured, substantial increases in the uninsured population may contribute to a decrease in US life expectancy.2 For many reasons, the problems of the US health care system have defied efforts to address them at the federal level. But federal inaction permits opportunity—the 50 states can step into the vacuum and move the country forward. Several states are now beginning to address the problems of the uninsured, as well as health care cost and quality. Although a few states can create and enact reform by themselves, the federal government can and should facilitate state initiatives.
Garson A, Blumenthal D. State-Federal Partnerships for Access to CareAn End and a Means. JAMA. 2007;297(10):1112-1115. doi:10.1001/jama.297.10.1112