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Lack of Health Insurance Among Health and Insurance Personnel

David U. Himmelstein, MD; Steffie Woolhandler, MD, MPH

JAMA. 1991;266(3):399-401.

Abstract
Objective.
—To analyze the health insurance status of physicians, other health personnel, and insurance industry personnel.

Design.
—The study was based on data collected by the US Bureau of the Census in the March 1991 Current Population Survey for six groups of workers in health care occupations and three classifications of insurance employees. This survey included 6182 civilian health personnel and 1498 insurance workers under the age of 65 years.

Results.
—Of civilian health personnel under the age of 65 years, 9% (90% confidence interval [Cl], 8.2% to 9.8%) are uninsured, equivalent to 834 000 persons, including 15 000 (90% Cl, 5000 to 25 000) physicians. Among insurance workers, 5.1% (90% Cl, 3.9% to 6.2%) are uninsured. While 6% (90% Cl, 4.2% to 7.9%) of those working in physicians' offices are uninsured, 52.2% (90% Cl, 48.2% to 56.3%) receive no employer contribution toward their coverage. More than a fifth of nursing home employees lack insurance coverage, as do nearly a quarter of the 1.868 million health care workers with annual incomes less than $10 000.

Conclusion.
—Nearly a million health care and insurance workers are themselves uninsured and at high risk for being unable to obtain needed care.

(JAMA. 1991;266:399-401)

Author Affiliations
From the Public Citizen Health Research Group (Dr Himmelstein), Washington, DC, and the Department of Medicine (Drs Himmelstein and Woolhandler), Center for National Health Program Studies, The Cambridge (Mass) Hospital and Harvard Medical School, Cambridge, Mass.

Footnotes
Reprint requests to The Cambridge Hospital, 1493 Cambridge St, Cambridge, MA 02139 (Dr Himmelstein).

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