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May 1991

Access to Care—The Problem for the Uninsured and Underinsured: The View From Washington

Author Affiliations

Alexandria, Va

Arch Otolaryngol Head Neck Surg. 1991;117(5):490-492. doi:10.1001/archotol.1991.01870170036007

The fact that some 30% of the US population is uninsured or underinsured underscores the urgency to address the growing problem of many Americans lacking access to health care. The past year has seen some 15 different proposed plans in Congress to deal with the uninsured, plus the Pepper Commission recommendations. The problem of access to health care involves issues of cost, quality of care, and the hassle factor of burdensome administrative paperwork.

The problem is being addressed both at the Federal and state levels. The only federal regulation that I am aware of that directly concerns access is the "antidumping" regulation passed in 1986. This action was designed to prohibit hospitals from refusing treatment to indigent patients with medical emergencies, including women in labor. Changes effective July 1, 1990, tightened requirements and stiffened penalties. The amended regulation requirements basically state that if a Medicare-participating hospital has an emergency room,