RWJF Scholar examines neighborhood-based death rates from opiate-based painkiller overdoses, compared with heroin overdose deaths.
Between 2000 and 2004, the Institute of Medicine (IOM) of the National Academy of Sciences, Washington, studied how the lack of health insurance affects individuals, families, communities and the nation and produced and disseminated six reports analyzing these consequences.
The project accomplished the following:
The Robert Wood Johnson Foundation (RWJF) funded the 42-month project with a $3.7-million grant between September 2000 and February 2004.
Numerous studies have established that people without health insurance are more likely to delay or forgo needed medical care and experience worse health outcomes. However, these and other consequences of being uninsured are not well known.
A 1999 opinion poll by the Harvard University School of Public Health found that 57 percent of the public believed the uninsured are able to get the health care they need when they need it. RWJF funded the poll (ID# 030110), which also showed that many Americans are unaware of the large number of people who lack insurance. Only 28 percent of Americans knew that the uninsured population numbered 40 million. (As of 2003, the number had increased to 45 million, according to the U.S. Census Bureau.)
In 1996, the IOM began a multiyear assessment of the quality of U.S. health care. The IOM produced a 1999 report on preventable medical errors (entitled To Err is Human: Building a Safer Health System) that received widespread attention in the popular media as well as professional circles.
The IOM's work on quality showed a significant relationship between quality of care received and health insurance and spurred the decision to conduct a separate study that would address all facets of the coverage problem, including indirect social and economic impacts of insurance coverage as well as the direct effects on individuals.
The IOM is both an honorific membership organization and a policy research organization that provides scientifically informed analysis and evidence-based advice to the nation on matters of medicine and health and is a component of the National Academy of Sciences. Although not a government agency, it has a responsibility to advise the federal government on medical issues.
Generally, the IOM evaluates and synthesizes studies done by others rather than conducting original research of its own. The organization does its work through committees of experts who serve without compensation. Reports go through a peer-review process before release to the public.
One of RWJF's major goals is to assure that all Americans have access to quality health care at reasonable cost. To further that goal, RWJF over the years has pursued various strategies to expand insurance coverage. One strategy is developing and communicating information aimed at raising awareness of the coverage problem among both policy-makers and the public, and stimulating policy solutions.
In the late 1990s and early 2000s, RWJF undertook a series of activities designed to engage the public more fully in the coverage issue and raise the problem's priority on the national agenda. As part of this effort, RWJF was interested in supporting a rigorous analysis of the health, economic and social consequences of being uninsured and communicating the findings in a manner that would have an impact on policy-makers, opinion leaders and the general public.
RWJF leaders knew that the IOM was also interested in the coverage problem and considered the IOM an ideal choice to undertake the uninsurance study given the respect the organization enjoys in both the scientific community and health policy world. The response to the report on medical errors attested to the impact that an IOM study could have.
However, RWJF personnel understood that insurance coverage is not, intrinsically, as compelling a subject as medical error. Although the National Academies include a communications staff responsible for releasing reports to the media, RWJF wanted to enlist the services of outside public relations professionals to mount a comprehensive communications campaign to promote the IOM's findings.
A key component of RWJF's communications strategy was that instead of one large report at the end of the grant period, the IOM would issue a series of reports over the life of the project, each one focused on a specific topic. The aim was a multi-report approach to increase attention to the research findings.
In July 2000, the RWJF Board of Trustees authorized spending up to $4.9 million on the project over three years, later extended to 42 months. The authorization included:
The IOM began its work by appointing a 16-member Committee on the Consequences of Uninsurance to select six report topics, oversee the study and issue the reports. Mary Sue Coleman, now president of the University of Michigan, and Arthur L. Kellermann, chair of the department of emergency medicine at Emory University School of Medicine, co-chaired the committee. Academics and business executives in health care-related fields filled the other slots. For the membership list, see Appendix 1.
The committee considered various potential topics for the six reports, including the effect of a lack of insurance on specific chronic conditions and on public health generally. Before selecting the final six topics, the committee held a full-day workshop at which researchers, health care executives and other experts presented their views on the coverage problem, including ways in which public understanding of health insurance issues could be improved. (See Bibliography for workshop details.) Also, the IOM posted possible report topics on the project Web site and solicited comment from the public.
Working with IOM staff and consultants from the communications firm of Porter Novelli, the committee in early 2001 settled on the following report topics and release dates:
To review the research literature, evaluate the evidence and prepare the individual reports, the IOM formed six subcommittees, one for each report. The subcommittees included both full committee members and external appointees from the research community, industry and government.
Paid consultants assisted the committee and subcommittees, preparing background papers on technical areas, analyzing data and synthesizing the research literature. In addition, the subcommittees heard presentations by experts from a wide range of disciplines.
The IOM's staff members conducted literature searches, assembled a Bibliography of relevant articles and studies, helped draft and edit the reports and maintained a research database.
For each report, the IOM formed a panel of independent reviewers to read the draft version and make written comments, which were addressed before the report was issued publicly.
For the first three reports, the committee and subcommittees based the findings almost exclusively on existing research and epidemiological data. For example, project personnel evaluated more than 250 studies to determine the adult and pediatric health outcomes that result from a lack of coverage. Altogether, the project made use of more than 1,000 source documents, according to Wilhelmine Miller, project co-director.
However, for the fourth and fifth reports—those focused on the consequences for communities and the nation—the committee found the published research limited and commissioned three pieces of original research:
These analyses, which the IOM funded with its RWJF grant, helped inform the findings of the fourth and fifth reports respectively. (See Findings, Conclusions and Recommendations.) The reports' appendices described the methodology and results of these commissioned studies.
In addition, at the IOM's request, RWJF separately funded research by the New York Academy of Medicine into how family dynamics—including family structure, levels of stress, psychological well-being and risk-taking attitudes—influence health insurance coverage, access to care and use of health services. The IOM found literature in this area sparse and wanted the new study to beef up the project's research base.
Under a $133,283 RWJF grant (ID# 042099), New York Academy of Medicine investigators analyzed two national surveys dealing with health care. The IOM report on family impacts incorporated a limited amount of the New York Academy study. (Appendix 2 summarizes the study process and findings.)
Initially, project leaders expected each of the six reports to be a monograph ranging from 80 to 100 pages. Once into the work, however, the committee saw that the body of research and the need to satisfy the IOM's peer-review process required the reports to be far longer.
In another deviation from original plans, the committee delayed publication of the sixth report until early 2004, and RWJF extended the grant period by six months to accommodate the change. The delay allowed use of new insurance coverage statistics from the U.S. Census Bureau as well as more time to plan for dissemination of the project's final product. (See Communications.)
Porter Novelli's Role
Through a competitive process, RWJF selected Porter Novelli, a Washington-based communications firm, to help disseminate the IOM findings and reports through:
In October 2001, RWJF awarded Porter Novelli a six-month contract (ID# 039965) to obtain relevant market research, devise a dissemination strategy and begin work on the Web site. RWJF anticipated that on completion of this initial stage, Porter Novelli would receive a second, larger contract to implement the strategy and complete the Web site.
Porter Novelli personnel reviewed public opinion data and other market research pertaining to the coverage issue and conducted eight focus groups designed to help identify specific aspects of the problem that the institute reports should focus on.
Four of the focus groups were in Washington with congressional staff and other policy leaders, and two each were in Chicago and Richmond, Va. with citizens engaged in political and social issues. The focus group participants voiced support for reducing the number of uninsured and identified "themes" that they found helpful in understanding the issue. For example, the message that people "who lack insurance often do not get the medical care they need" ranked highest among both policy leaders and engaged citizens, Porter Novelli reported.
The firm also drafted a three-year strategic plan for promoting the IOM's reports.
Following RWJF's selection of Porter Novelli, the IOM—using RWJF grant funds and with RWJF's concurrence—contracted with the same firm to provide communications advice directly to the project. The IOM has strict confidentiality requirements and will not share information on a developing study with an outside entity unless the entity is working for the IOM and has signed a confidentiality agreement.
In their capacity as IOM consultants, Porter Novelli personnel briefed the committee on the focus group results and other market research findings, including common public misperceptions of the coverage problem and the relative strength of messages to improve understanding of the issue. As the committee developed its plan, the firm offered strategic advice, including recommending options for the individual report topics. Also, during the drafting of the first report, the firm provided editorial advice on effective communication of the findings.
An Early End to Porter Novelli's Involvement. The IOM's confidentiality requirements—aimed at protecting the impartiality of the research and the reputation of the organization—extend to the financial sponsor of a study. Thus, RWJF was not privy to the committee's deliberations and could not get a preview of the findings significantly in advance of their public release. IOM rules provide that a sponsor may not receive a report more than 14 days before the official release date, according to Miller, the project co-director. What's more, under its confidentiality agreement with the IOM, Porter Novelli could not share its inside knowledge of the project with RWJF, which was funding the firm's work.
In the view of RWJF personnel, the IOM's confidentiality requirements made it difficult to carry out an aggressive communications campaign coordinated with the report releases, since planning a comprehensive promotional effort requires knowing well in advance exactly what is to be promoted. In addition to precluding collaborative planning with the IOM, the prohibition on information sharing limited RWJF's ability to manage Porter Novelli's work.
RWJF therefore decided that under the circumstances, a separate communications campaign was not feasible. Consequently, RWJF dropped its plan for a second contract with Porter Novelli. RWJF subsequently used the remainder of the $1.2-million communications allocation to help fund the first Cover the Uninsured Week, a week-long national public education campaign in March 2003 to raise awareness of the uninsured problem and elevate the issue on the national agenda (Communications Project ID# 044968). (RWJF supported a second Cover the Uninsured Week in May 2004 and plans another for May 2005.) RWJF also funded continued dissemination of the six reports through ID# 045205, an internal grant through which RWJF could contract with communications firms for this purpose.
Once RWJF curtailed its separate communications effort, the IOM ended its own relationship with Porter Novelli.
The project accomplished the following:
The title, release date and some of the key conclusions, findings and/or recommendations of each report follow:
Coverage Matters: Insurance and Health Care, October 11, 2001
Care Without Coverage: Too Little, Too Late, May 21, 2002
Health Insurance Is a Family Matter, September 18, 2002
A Shared Destiny: Community Effects of Uninsurance, March 6, 2003
Hidden Costs, Value Lost: Uninsurance in America, June 17, 2003
Insuring America's Health: Principles and Recommendations, January 14, 2004
Committee members, IOM staff and employees of the National Academies' Office of News and Public took a number of steps to promote the six reports and make the findings accessible to the public and policy-makers, including:
For details of many of the project's communications activities, see the Bibliography.
The IOM's early reports received some national and regional news coverage in the print media—6–10 articles per report on average—and mention in a few professional journals. The final report—presenting the committee's recommendations—got far broader coverage, which the co-directors attributed to the impact of the previous reports and to an enhanced communications strategy, notably the National Press Club event and the video news release. The co-directors reported the following responses to the final report:
Outside events presented a challenge to the project's communications effort. The September 11th terrorist attacks on New York and Washington forced a one-month postponement in the first report's release, which had been scheduled for September 12, 2001. Even then, media coverage of the report was more limited than for the subsequent reports. Also, the anthrax attacks on Capitol Hill in the fall of 2001 made it logistically more difficult to get the reports and related materials to congressional offices.
At the project's conclusion, co-directors Miller and Wolman reported the following lessons to RWJF:
In response to the recommendations in the IOM's final report, the RWJF board in October 2004 approved a three-pronged strategy calling for RWJF to:
Detailed planning remained underway, but the strategy anticipated that in 2005 RWJF would lead a major national campaign on the coverage issue, was indeed the case. While building on the strengths of the 2003 and 2004 Cover the Uninsured Week efforts, the 2005 campaign differed by focusing heavily on the IOM's goal and recommendations.
Also, as part of the strategy, RWJF planned to explore the feasibility and strategic value of establishing a national advocacy organization for coverage issues. As the RWJF-funded Campaign for Tobacco-Free Kids did for the tobacco control movement, the new organization would serve as a base for future campaign activities on the coverage problem. In addition, the strategy called for RWJF to play a leading role in assessing reform proposals and determining the extent to which they follow the five principles listed in the IOM's final report.
In 2008, RWJF provided additional funding to the National Academy of Sciences/Institute of Medicine. Under Grant ID# 063982, the IOM updated its previous series of reports on the consequences of uninsurance with respect to recent trends in insurance coverage, health effects of uninsurance, and the impact of uninsurance on communities.
The objective was achieved and reported in book form as well as in a summary Report Brief. The book, America's Uninsured Crisis: Consequences for Health and Health Care, provides detailed descriptions of the research methods, findings, and research bibliography.
The work conducted under Grant ID# 063982 supported the findings from the previous IOM report series on uninsurance and provided even stronger evidence that health insurance matters. This report makes it clear that people without insurance do not receive the health care they need.
Surveying the Consequences of Uninsurance
National Academy of Sciences - Institute of Medicine (Washington, DC)
New York Academy of Medicine (New York, NY)
Gerry Fairbrother, Ph.D.
Porter Novelli (Washington, DC)
Committee on the Consequences of Uninsurance
Mary Sue Coleman, Ph.D., Co-chair
President, University of Michigan
Ann Arbor, Mich.
Arthur L. Kellermann, J.D., M.P.H., Co-chair
Professor and Chair Department of Emergency Medicine
Director, Center for Injury Control
Ronald M. Andersen, Ph.D.
Wasserman Professor in Health Services
Chair, Department of Health Services
Professor of Sociology
School of Public Health
University of California
Los Angeles, Calif.
John Z. Ayanian, M.D., M.P.P.
Associate Professor of Medicine and Health Care Policy
Harvard Medical School
Brigham and Women's Hospital
Robert J. Blendon, Sc.D.
Professor, Health Policy and Political Analysis
Department of Health Policy and Management
Harvard School of Public Health and Kennedy School of Government
Sheila P. Davis, Ph.D., R.N.
University of Mississippi Medical Center
School of Nursing
George C. Eads
Charles River Associates
Sandra R. Hernandez, M.D.
Chief Executive Officer
San Francisco Foundation
San Francisco, Calif.
Willard G. Manning, Ph.D.
Professor, Department of Health Studies
University of Chicago
James J. Mongan, M.D.
President and CEO
Partners HealthCare, Inc.
Chief Executive Officer
Employer Health Care Alliance Cooperative
Shoshanna Sofaer, Dr.P.H., M.P.H.
Robert P. Luciano Professor of Health Care Policy
School of Public Affairs
New York, N.Y.
Stephen J. Trejo, Ph.D.
Associate Professor, Department of Economics
University of Texas
Reed V. Tuckson, M.D.
Senior Vice President, Consumer Health and Medicare Care Advancement
Edward H. Wagner, M.D., M.P.H.
Director, MacColl Institute for Healthcare Innovation
Center for Health Studies, Group Health Cooperative
Lawrence Wallack, Dr.P.H.
Director, School of Community Health
College of Urban and Public Affairs
Portland State University
'Research on Factors That Affect Health Care Coverage, Access and Use Among Families' - a project funded by RWJF (ID# 042099)
Researchers at the New York Academy of Medicine examined the influence of various family dynamics on health insurance coverage, access to care and use of health services. The dynamics studied included family structure, stress levels, psychological well-being and risk-taking attitudes. The researchers also measured how parents' health insurance status affected their children's access to, and use of, health care. RWJF funded the research with a $133,283 grant (ID# 042099) at the request of the IOM, which wanted the information to help inform a study of how the lack of health insurance affects families.
Under the RWJF grant, the New York Academy of Medicine study team analyzed data from the 1999 National Survey of American Families and the 1996 Medical Expenditure Panel Survey. The National Survey of American Families is a household survey sponsored by the Urban Institute's Assessing the New Federalism Project. The survey includes information on health insurance coverage, access to care and use of health services. The Medical Expenditure Panel Survey, conducted under the auspices of the federal Agency for Healthcare Research and Quality and the National Center for Health Statistics, collects data on the health services that Americans use and how they pay for them.
The principal investigator reported the following findings to RWJF:
Health Insurance is a Family Matter—the third report in the IOM's six-volume series on the consequences of uninsurance—incorporated a limited amount of research from this study. The study also resulted in three unpublished articles and an abstract that was accepted for presentation at the 2003 annual meetings of the Pediatric Academic Societies and AcademyHealth. (For the titles of the unpublished articles, see two articles by Fairbrother and one by Hanson in the Bibliography.)
For additional information about this research, contact Gerry Fairbrother, Ph.D., the chief investigator, at (212) 822-7398 or email@example.com.
(This appendix is excerpted from Grant Results on ID# 042099.)
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. America's Uninsured Crisis: Consequences for Health and Health Care. Washington, DC: National Academies Press, 2009.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Coverage Matters: Insurance and Health Care. Washington: National Academy Press, 2001.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Coverage Matters: Insurance and Health Care. Executive Summary. Washington: National Academy Press, 2001.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little Too Late. Washington: National Academy Press, 2002.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little Too Late. Executive Summary. Washington: National Academy Press, 2002.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Health Insurance is a Family Matter. Washington: National Academy Press, 2002.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Health Insurance is a Family Matter. Executive Summary. Washington: National Academy Press, 2002.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. A Shared Destiny: Community Effects of Uninsurance. Washington: National Academy Press, 2003.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. A Shared Destiny: Community Effects of Uninsurance. Executive Summary. Washington: National Academy Press, 2003.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Hidden Costs, Value Lost: Uninsurance in America. Washington: National Academy Press, 2003.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Hidden Costs, Value Lost: Uninsurance in America. Executive Summary. Washington: National Academy Press, 2003.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Insuring America's Health: Principles and Recommendations. Washington: National Academy Press, 2004.
Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance. Insuring America's Health: Principles and Recommendations. Executive Summary. Washington: National Academy Press, 2004.
All the above are also available online.
Ayanian JZ. "Uninsured and Untreated." Albany Times-Union, July 7, 2002.
Ayanian JZ. "A Tale of Two Patients." Peoria Journal Star, July 21, 2002.
Coleman MS. "A Closer Look at Uninsured Americans." Everett Herald, November 2001.
Coleman MS. "A Closer Look at Uninsured Americans." Peoria Journal Star, December 23, 2001.
Coleman MS. "Problems of Uninsured Directly Affect All Americans." USA Today, February 24, 2004.
Fairbrother G. "Commentary on IOM Report: Health Insurance is a Family Matter." Ambulatory Pediatrics, 3: 66–67, 2003.
Fairbrother G, Hanson K, Kenney G, Dubay L and Ramalingam N. "How Do Stressful Family Environments Relate to Enrollment in Health Insurance by Low-Income Children and Parents?" AcademyHealth Meeting, 20: abstract no. 296, 2003. Abstract available online.
Fairbrother G, Kenney G, Hanson K and Dubay L. "How Do Stressful Family Environments Relate to Reported Access and Use of Health Care by Low-Income Children?" Medical Care Research and Review, 62(2): 205–230, 2005. Abstract available online.
Glied S. "A Health Bargain on the Job." Los Angeles Times, October 14, 2003.
Hanson K. "Parental Insurance and Children's Access and Utilization Among Insured Children." Unpublished.
Kellermann AL. "Uninsured in America: Truth and Consequences." Atlanta Journal-Constitution, December 25, 2001.
Kellermann AL. "Cuts to Medicaid Will Hurt Health Care for Everyone." Atlanta Journal-Constitution, July 11, 2003.
Kellermann AL. "Pain and Suffering Ensued." Atlanta Journal-Constitution, October 1, 2003.
Kellermann AL. "Physician Support for Covering the Uninsured: Is the Cup Half Empty or Half Full?" Annals of Internal Medicine, 139(November): 858–859, 2003.
Kellermann AL and Fairbrother G. "Family Interdependencies and the Family Physician." Journal of the American Board of Family Practice, 16(1): 81–82, 2003.
Kellermann AL and Miller W. "Can America Afford Not To Provide Universal Health Care?" The Forward, December 5, 2003.
Miller WD, Vigdor E and Manning W. "Covering the Uninsured: What Is It Worth?" Health Affairs Web Exclusives, March 31, 2004. Available online.
Needleman J, Sofaer S, Snyder LP and Anderson R. "Community Effects of Uninsurance: What Do We Need To Know?" Unpublished.
Queram C. "Insured, Uninsured Have Shared Destiny." Wisconsin State Journal, March 30, 2003.
Queram C. "Chris Queram Comments on IOM Report." Wisconsin Hospital Association Valued Voice, February 6, 2004.
Wagner E. "Health Care A Crucial Campaign Issue." Seattle Post-Intelligencer, January 20, 2004.
Wallack L. "In My Opinion Health Insurance Must Be Made Universal." Oregonian, January 17, 2004.
Wolman DM and Miller W. The Consequences of Uninsurance for Individuals, Families, Communities, and the Nation. Journal of Law, Medicine & Ethics, 32(3): 397–403, 2004.
America's Uninsured Crisis: Consequences for Health and Health Care. Washington, DC: National Academies, available online.
Institute of Medicine. Coverage Matters: Insurance and Health Care. Washington: Institute of Medicine, 2001.
Institute of Medicine. Estar Cubierto Por Unseguro De Salud es Importante: Seguro de Salud Y Atencion Medica. Washington: Institute of Medicine, 2001.
Institute of Medicine. Atencion Medica Sin Cobertura: Si No Es Suficiente, Es Demasiado Tarde. Washington: Institute of Medicine, 2002.
Institute of Medicine. El Seguro De Salud Es Un Asunto Familiar. Washington: Institute of Medicine, 2002.
Institute of Medicine. Health Insurance Is a Family Matter. Washington: Institute of Medicine, 2002.
Institute of Medicine. A Shared Destiny: Community Effects of Uninsurance. Washington: Institute of Medicine, 2003.
Institute of Medicine. Costos Escondidos, Valor Perdido: La Falta De Seguro De Salud En Los Estados Unidos. Washington: Institute of Medicine, 2003.
Institute of Medicine. Hidden Costs, Value Lost: Uninsurance in America. Washington: Institute of Medicine, 2003.
Institute of Medicine. Un Destino Compartido: Effectos De La Falta Seguro En Individuos, Familias Y Comunidades. Washington: Institute of Medicine, 2003.
Institute of Medicine. Asegurando La Salud De Los Estados Unidos: Principios Y Recomendaciones. Washington: Institute of Medicine, 2004.
Institute of Medicine. Insuring America's Health: Principles and Recommendations. Washington: Institute of Medicine, 2004.
Institute of Medicine. Uninsurance Checklist. Assessing Proposals for Major Health Insurance Reform. Principles for Eliminating Uninsurance. Washington: Institute of Medicine, 2004.
Institute of Medicine. Fact Sheets. Washington: Institute of Medicine, 2004:
Porter Novelli. Focus Group Research on Perceptions That Currently Frame the Issue of the Uninsured in America. Washington: Porter Novelli, 2001.
Porter Novelli. Three Year Strategic Plan To Promote IOM Studies on Americans Who Lack Health Insurance (Revised). Washington: Porter Novelli, 2001.
Insuring Health: The First Four Reports and Summaries of the Committee on the Consequences of Uninsurance 2001–2003, CD-ROM software containing the first four reports and English-language and Spanish-language summaries. Washington: Institute of Medicine, 2003.
Insuring Health: The Six Reports and Summaries of the Committee on the Consequences of Uninsurance 2001–2004, CD-ROM software containing all six reports and English-language and Spanish-language summaries. Washington: Institute of Medicine, 2004.
Video News Release, produced by Home Front Communications to support the Institute of Medicine report Insuring America's Health: Principals and Recommendations, Washington: Home Front Communications, 2004.
www.iom.edu/?ID=4660. "Consequences of Uninsurance" on the Institute of Medicine Web site provides information about the Committee on the Consequences of Uninsurance and the six reports the committee produced. Washington: Institute of Medicine, 2001.
www.nas.edu/onpi. "Office of News and Public Information" on the National Academies Web Site provides general information about Institute of Medicine work in the area of insurance coverage, including the Committee on the Consequences of Uninsurance. Washington: National Academies of Science.
Mary Sue Coleman and Shoshanna Sofaer, congressional briefing on the report Coverage Matters: Insurance and Health Care, October 10, 2001, Washington. No written invitation; arranged by the National Academies' Office of Congressional and Government Affairs.
Arthur Kellermann, "Coverage Matters: Insurance and Health Care," to the Subcommittee on Health of the House Committee on Energy and Commerce, February 28, 2002, Washington.
Mary Sue Coleman and Edward Wagner, congressional briefing on the report Care Without Coverage: Too Little, Too Late, May 20, 2002, Washington. No written invitation; arranged by the National Academies' Office of Congressional and Government Affairs.
George Eads and Shoshanna Sofaer, congressional briefing on the report Health Insurance Is a Family Matter, September 17, 2002, Washington. No written invitation; arranged by the National Academies' Office of Congressional and Government Affairs.
George Eads and Shoshanna Sofaer, briefing of the assistant secretary for planning and evaluation, U.S. Department of Health and Human Services, on Health Insurance Is a Family Matter, September 17, 2002, Washington. Request from Deputy Assistant Secretary Eve Slater.
Wilhelmine Miller, briefing for Senator Max Baucus (D-Mont.) and staff, December 18, 2002, Washington. Telephoned request from Senator Baucus's office.
Arthur Kellermann, briefing of the Health Subcommittee of the Senate Health, Education, Labor and Pensions Committee on the report A Shared Destiny: Community Effects of Uninsurance, March 5, 2003, Washington. No written invitation; arranged by the National Academies' Office of Congressional and Government Affairs.
Harvey V. Fineberg, "Health Care for All: Finding Common Ground," to a congressional briefing organized by the American Public Health Association, March 18, 2003, Washington.
Arthur Kellermann, "A Shared Destiny: Effects of Uninsurance on Individuals, Families and Communities," to the Subcommittee on Labor, Health and Human Services and Education of the Senate Committee on Appropriations, April 30, 2003, Washington. Written request from the subcommittee's minority staff director.
James Mongan, congressional briefing on Hidden Costs, Value Lost: Uninsurance in America, June 16, 2003, Washington. No written invitation; arranged by the National Academies' Office of Congressional and Government Affairs.
Wilhelmine Miller, presentation "Hidden Costs, Value Lost" on the C-SPAN call-in show "Washington Journal," June 21, 2003, Washington. Invitation of C-SPAN.
Wilhelmine Miller, "The Uninsured—Hidden Costs, Value Lost," to the New Mexico State Legislature Health and Human Services Committee, August 4, 2003, Santa Fe, NM.
Wilhelmine Miller, "Hidden Costs, Value Lost: Uninsurance in America," to the Health Resources and Services Administration's State Planning Grants Meeting, November 4, 2003, Washington. (PowerPoint slides.)
Arthur Kellermann and Shoshanna Sofaer, congressional briefing on the report Insuring America's Health: Principles and Recommendations, January 13, 2004, Washington. No written invitation; arranged by the National Academies' Office of Congressional and Government Affairs. (PowerPoint slides.)
John Ayanian, "Health Consequences of Uninsurance: Research Findings and Policy Implications," at the Research Seminar Series, Leonard Davis Institute of Health Economics, University of Pennsylvania, January 14, 2004, Philadelphia. (PowerPoint slides.)
John Ayanian and Shoshanna Sofaer, briefing for the assistant secretary for planning and evaluation, U.S. Department of Health and Human Services, on the report Insuring America's Health: Principles and Recommendations, January 14, 2004, Washington. Request by the assistant secretary, Mike O'Grady. (PowerPoint slides.)
Shoshanna Sofaer, "Key Principles for Covering the Uninsured," to the Alliance for Health Reform, January 16, 2004, Washington. Webcast available online.
Wilhelmine Miller and Dianne Wolman, "Insuring America's Health: Principles and Recommendations," to the Democratic Leadership Caucus (health section), January 23, 2004, Washington. Request from staff member. (PowerPoint slides.)
Jack Ebeler and Shoshanna Sofaer, "Insuring America's Health: Principles and Recommendations," at a breakfast session organized by AcademyHealth, January 28, 2004, Washington.
Shoshanna Sofaer, "Insuring America's Health: Principles and Recommendations," at a symposium organized by Baruch College School of Public Affairs, February 5, 2004, New York. Proceedings available online. (PowerPoint slides.)
Report prepared by: Michael H. Brown
Reviewed by: Kelsey Menehan
Reviewed by: Marian Bass
Program Officer: Anne F. Weiss
Communications Officer: Stuart M. Schear
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