UA News

A group of UA faculty members and those practicing at the Arizona Health Sciences Center have contributed to a new book about uninsured Americans in the United States, what problems they face and what resources are available to them.

The medical care of Americans who have no health insurance is the topic of a new book whose co-editors and contributors include University of Arizona faculty members. 

The book, "The Care of the Uninsured in America," was published by Springer and features chapters written by several UA College of Medicine faculty members.

Among the contributors are Dr. Francisco Moreno, Lynne Tomasa, Dr. Theresa Cullen and Dr. James Dalen, who also is a former UA College of Medicine dean. Also, Dr. Howard Eng, an assistant professor in the UA Mel and Enid Zuckerman College of Public Health, is a contributor.

Dr. Lane Johnson, an clinical associate professor in the UA's family and community medicine department, and Nancy Johnson, an adjunct faculty member of the UA College of Nursing, co-edited the book. The Johnsons, who are married, are both members of the UA's Arizona Health Sciences Center.
 
The book identifies sub-populations of the uninsured and:

• Outlines necessary skills and strategies for working with uninsured patients, from health promotion to cultural competency
• Offers models and case examples of innovative care programs
• Reports on methods for improving access and support
• Describes medication-assistance programs
• Discusses chronic care and disease management
• Analyzes the health-care reform debate and makes recommendations.

"There seemed to be a need to gather many topics together to help paint a comprehensive picture of the challenge of the uninsured in our country – one that would be useful for health professionals and students as well as our legislators and policymakers," said Nancy Johnson, who is also chief operating officer at the El Rio Community Health Center in Tucson

"People think the uninsured are the poor, homeless, new immigrants and the mentally ill, when in reality, the uninsured are a very diverse group of all ethnicities, all ages and with
many different health challenges. Any of us could become uninsured; some of us are at greater risk," she said.

Dr. Lane Johnson also said he has had at least a half-dozen patients who have lost their jobs and, subsequently, their insurance in the last year.

For those unable to get basic care for chronic and easily treatable conditions like asthma, heart disease and diabetes the risk is "catastrophic problems" that will then require emergency treatment,  he said. 

"The subsequent medical bills further exacerbates the problem of access and costs that are the reason medical bills are a major reason for bankruptcy in the United States," he said.

The editors are not surprised by the bumpy road toward any sort of national health-care reform.

"I think the challenge is that our health-care system is so very complicated," Nancy Johnson said.

"Decisions come with unintended consequences that our lawmakers may not recognize," she said. "We hope our book educates legislators about the complexity of the problem, what their constituents and the nation's health-care professionals are doing to help and what might be possible solutions."

Primary care and prevention are critical to help build healthier populations and communities, the editors assert. The book identifies a number of existing programs around the nation that are improving services to the uninsured.

Dr. Lane Johnson said: "This is an issue for which all of us need to take responsibility and figure out how to make it work."