When 41,000,000 people lack health insurance, it is not just the uninsured and their families who suffer, cautions a group of organizations sponsoring Cover the Uninsured Week (March 10-16). The impact is felt on the nation’s economy and health care system, as well as in the communities in which they live. Not having health insurance is a leading cause of personal bankruptcy. Moreover, the large number of uninsured patients often overwhelms hospital emergency rooms and other health facilities.

People without health insurance get sicker and are more likely to die sooner than those who have it. those who have insurance tend to have better health and receive better, more-timely care across a range of preventive, chronic, and acute care services than those who do not. In a study of more than 28,000 patients, those without insurance were more likely to be diagnosed with skin, colorectal, breast, and prostate cancers at a later, more-dangerous stage than those with insurance. All of these cancers can be detected earlier through regular screening–an option usually unavailable to the uninsured. According to another study of breast cancer patients, uninsured women had a 49% greater chance of dying following diagnosis of the disease than did privately insured women.

Also, for uninsured Americans with chronic conditions, lack of access to needed care results in more medical crises and emergency hospitalizations. People without insurance are up to 70% more likely to be hospitalized for ailments such as diabetes, hypertension, pneumonia, and bleeding ulcers than those with insurance. Uninsured people tend to be sicker upon admission to the hospital, and are more likely than the privately insured to die there.

The uninsured in some communities may obtain basic health care services through “safety net providers” such as community health centers, hospital clinics, and free health clinics. In many communities, though, these facilities have limited hours, long waiting periods, and are not equipped to provide medicines or treatment for complicated illnesses, so many of the uninsured rely on the nearest hospital emergency room for treatment when they or their family members are sick. The ER, however, is neither the most-effective nor most-efficient setting for treating most health problems. It does not provide a continuum of care for uninsured patients once they are discharged.

Many hospitals and physicians provide charity care to low-income, uninsured patients at no or reduced charge, but that care imposes a cost on society. It is often paid for indirectly by insured patients, who wind up with higher charges as a result. Taxpayers also pay through Federal and state subsidies to the hospitals and clinics that serve them. America’s hospitals incur substantial operating losses from high rates of uncompensated care, possibly forcing them to cut back on their services to all patients or even close their facilities.