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Care Without Coverage: Too Little, Too Late (2002)

Chapter: Appendix E Biographical Sketches

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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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Suggested Citation:"Appendix E Biographical Sketches." Institute of Medicine. 2002. Care Without Coverage: Too Little, Too Late. Washington, DC: The National Academies Press. doi: 10.17226/10367.
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E Biographical Sketches COMMITTEE ON THE CONSEQUENCES OF UNINSURANCE SUBCOMMITTEE ON THE HEALTH OUTCOMES OF THE UNINSURED Mary Sue Coleman, Ph.D., Co-chair, is president of the University of Iowa and president of the University of Iowa Health Systems. She holds academic appointments as professor of biochemistry in the College of Medicine and profes- sor of biological sciences in the College of Liberal Arts. Dr. Coleman served as provost and vice president for academic affairs at the University of New Mexico (1993–1995) and dean of research, and vice chancellor at the University of North Carolina at Chapel Hill (1990–1992). She was both faculty member and Cancer Center administrator at the University of Kentucky in Lexington for 19 years, where her research focused on the immune system and malignancies. Dr. Coleman is a member of the Institute of Medicine (IOM) and a Fellow of the American Association for the Advancement of Science. She serves on the Iowa Governor’s Strategic Planning Council, the Board of Trustees of the Universities Research Association, the Board of Governors of the Warren G. Magnuson Clinical Center at the National Institutes of Health, and other voluntary advisory bodies and corporate boards. Arthur L. Kellermann, M.D., M.P.H., Co-chair, is professor and director, Center for Injury Control, Rollins School of Public Health, Emory University, and professor and chairman, Department of Emergency Medicine, School of 167

168 CARE WITHOUT COVERAGE: TOO LITTLE, TOO LATE Medicine, Emory University. Dr. Kellerman has served as principal investigator or co-investigator on several research grants, including federally funded studies of handgun-related violence and injury, emergency cardiac care, and the use of emergency room services. Among his many awards and distinctions, he is a fellow of the American College of Emergency Physicians (1992); is the recipient of a meritorious service award from the Tennessee State Legislature (1993); the Hal Jayne Academic Excellence Award from the Society for Academic Emergency Medicine (1997); and was elected to membership in the IOM (1999). In addition, Dr. Kellermann is a member of the Editorial Board of the journal Annals of Emergency Medicine, and has served as a reviewer for the New England Journal of Medicine, the Journal of the American Medical Association, and the American Journal of Public Health. Ronald M. Andersen, Ph.D.,* is the Fred W. and Pamela K. Wasserman Professor of Health Services and professor of sociology at the University of Cali- fornia, Los Angeles School of Public Health. He teaches courses in health services organization, research methods, evaluation, and leadership. Dr. Andersen received his Ph.D. in sociology at Purdue University. He has studied access to medical care for his entire professional career of 30 years. Dr. Andersen developed the Behav- ioral Model of Health Services Use that has been used extensively both nationally and internationally as a framework for utilization and cost studies of general populations, as well as special studies of minorities, low income, children, women, the elderly, oral health, the homeless, and the HIV-positive population. He has directed three national surveys of access to care and has led numerous evaluations of local and regional populations and programs designed to promote access to medical care. Dr. Andersen’s other research interests include international com- parisons of health services systems, graduate medical education curricula, physician health services organization integration, and evaluations of geriatric and primary care delivery. He is a member of the IOM and was on the founding Board of the Association for Health Services Research. He has been chair of the Medical Sociology Section of the American Sociological Association. In 1994 he received the association’s Leo G. Reeder Award for Distinguished Service to Medical Sociology; in 1996 he received the Distinguished Investigator Award from the Association for Health Services Research; and in 1999 he received the Baxter Allegiance Health Services Research Prize. John Z. Ayanian, M.D., M.P.P.,* is an associate professor of medicine and health care policy at Harvard Medical School and Brigham and Women’s Hospi- tal, where he practices general internal medicine. His research focuses on quality of care and access to care for major medical conditions, including colorectal cancer and myocardial infarction. He has extensive experience in the use of cancer *Member of the Subcommittee on the Health Outcomes of the Uninsured

APPENDIX E 169 registries to assess outcomes and evaluate the quality of cancer care. In addition, he has studied the effects of race and gender on access to kidney transplants and on quality of care for other medical conditions. Dr. Ayanian is deputy editor of the journal Medical Care, a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar, and a fellow of the American College of Physicians. Robert J. Blendon, M.B.A., Sc.D., is currently professor of health policy and political analysis at both the Harvard School of Public Health and the John F. Kennedy School of Government; he has received awards for outstanding teaching from both institutions. He also directs the Harvard Opinion Research Program and the Henry J. Kaiser National Program on the Public, Health, and Social Policy, which focuses on the better understanding of public knowledge, attitudes, and beliefs about major domestic public policy issues. Dr. Blendon also codirects the Washington Post–Kaiser Family Foundation (KFF) survey project, which was nominated for a Pulitzer Prize, and a new project for National Public Radio and KFF on American attitudes toward health and social policy, which was cited by the National Journal as setting a new standard for public opinion surveys in broad- cast journalism. From 1987 to 1996, Dr. Blendon served as chair of the Depart- ment of Health Policy and Management at the Harvard School of Public Health and as deputy director of the Harvard University Division of Health Policy Re- search and Education. Prior to his Harvard appointments, Dr. Blendon was senior vice president at the Robert Wood Johnson Foundation. He was senior editor of a three-volume series The Future of American Health Care and is a member of the IOM, the advisory committee to the director of the Centers for Disease Control and Prevention, and the editorial board of the Journal of the American Medical Association. Dr. Blendon is a graduate of Marietta College and received his master’s of business administration and doctoral degrees from the University of Chicago and the Johns Hopkins School of Public Health, respectively. Sheila P. Davis, B.S.N., M.S.N., Ph.D., is associate professor, Department of Adult Health, in the School of Nursing at the University of Mississippi Medical Center. She is also vice president of Davis, Davis & Associates, a health manage- ment consultant company. Her research focuses on minority health issues, espe- cially cardiovascular risk among ethnic populations. Dr. Davis is the founder and chair of the Cardiovascular Risk Reduction in Children Committee at the Uni- versity of Mississippi. This is a multidisciplinary committee (physicians, nurses, dietician, health educator, college administrator, nurse practitioners, etc.) commit- ted to reducing cardiovascular risks in children. Dr. Davis is a member of the American Nurses’ Association and has written numerous publications on the profession and the experiences of ethnic minorities in the health professions. She is author of a faith-based program, Healthy Kids Seminar, that is used to promote the adoption of healthy life-style choices by children.

170 CARE WITHOUT COVERAGE: TOO LITTLE, TOO LATE Paula Diehr, Ph.D.,* is professor of biostatistics and health services at the University of Washington in Seattle. She is currently a member of the Health Services Research and Development Scientific Review and Evaluation Board for the Department of Veterans Affairs. Dr. Diehr serves on the editorial boards of Statistics in Medicine, Health Services Research, Annual Review of Public Health, and the forthcoming Encyclopedia of Biostatistics. She received the award for excellence in public health statistics from the Statistics Section of the American Public Health Association in 1991. She was named fellow of the American Statistical Association in 1994 and fellow of the Association for Health Services Research (AHSR) in 1996. Dr. Diehr has worked primarily in health services research. Her research focuses on the use of health services, with a special emphasis on mental health services; different insurance and provider plans; health status; efficient diagnostic algorithms for headache, cough, and ankle trauma; health services for older adults; people without health insurance; and survey research methods. Dr. Diehr is prob- ably best known for her work in small-area variation analysis. Her article on this topic won the 1991 AHSR award for “Article of the Year.” She is currently interested in statistical methods for the evaluation of community-based health promotion programs and in statistical issues involved in analyzing future years of healthy life for older adults. George C. Eads, Ph.D., is vice president and director of the Charles River Associates (CRA) Washington, D.C. office and is an internationally known expert in the economics of the automotive and airlines industries. Prior to joining CRA, Dr. Eads was vice president and chief economist at General Motors Corporation. He represented the corporation frequently before congressional committees and federal regulatory agencies. He has served as a member of the President’s Council of Economic Advisers and as a special assistant to the assistant attorney general in the Antitrust Division of the U.S. Department of Justice. Dr. Eads has published numerous books and articles on the impact of government on business and has taught at several major universities, including Harvard and Princeton. Sandra R. Hernández, M.D., is chief executive officer (CEO) of the San Francisco Foundation, a community foundation serving the five Bay Area coun- ties. It is one of the largest community foundations in the country. Dr. Hernández is a primary care internist who previously held a number of positions within the San Francisco Department of Public Health, including director of the AIDS Office, director of Community Public Health, county health officer, and finally director of health for the City and County of San Francisco. She was appointed to and served on President Clinton’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Among the many honors and awards *Member of the Subcommittee on the Health Outcomes of the Uninsured.

APPENDIX E 171 bestowed on her, Dr. Hernández was named by Modern Healthcare magazine as one of the top 10 health care leaders for the next century. Dr. Hernández is a graduate of Yale University, Tufts School of Medicine, and the JFK School of Government at Harvard University. She is on the faculty of the University of California, San Francisco (UCSF) School of Medicine and maintains an active clinical practice at San Francisco General Hospital in the AIDS Clinic. Willard G. Manning, Ph.D., is professor in the Department of Health Studies, Pritzker School of Medicine, and in the Harris School of Public Policy, at the University of Chicago. His primary research focus has been the effects of health insurance and alternative delivery systems on the use of health services and health status. He is an expert in statistical issues in cost-effectiveness analysis and small- area variations. His recent work has included examination of mental health ser- vices use and outcomes in a Medicaid population, and cost-effectiveness analysis of screening and treating depression in primary care. Dr. Manning is a member of the IOM. David O. Meltzer, M.D., Ph.D.,* is an assistant professor in the Department of Medicine and an associate faculty member of the Harris School and the Depart- ment of Economics at the University of Chicago. Dr. Meltzer’s research explores problems in health economics and public policy. His recent work has focused on the theoretical foundations of medical cost-effectiveness analysis, including issues such as accounting for future costs due to the extension of life and the empirical validity of quality-of-life assessment, which he has examined in the context of diabetes and prostate cancer. Another major area of study examines the effects of managed care and medical specialization on the cost and quality of care, especially in teaching hospitals. Dr. Meltzer is the recipient of numerous awards: the Na- tional Science Foundation Graduate Fellowship in Economics, the Lee Lusted Prize of the Society for Medical Decision Making, the Health Care Research Award of the National Institute for Health Care Management, and the Robert Wood Johnson Generalist Physician Award. He is also a faculty research fellow for the National Bureau of Economic Research and has served on a panel that examined the Future of Medicare for the National Academy of Social Insurance and served on the IOM Organ Procurement and Transplantation Policy Commit- tee. James J. Mongan, M.D., is president and chief operating officer of Massachu- setts General Hospital. He was previously executive director, Truman Medical Center, and dean, University of Missouri-Kansas City School of Medicine. Dr. Mongan served as assistant surgeon general in the Department of Health and *Member of the Subcommittee on the Health Outcomes of the Uninsured.

172 CARE WITHOUT COVERAGE: TOO LITTLE, TOO LATE Human Services (DHHS), as former associate director for health and human resources, Domestic Policy Staff, the White House; and as former deputy assistant secretary for Health Policy, Department of Health, Education and Welfare. Dr. Mongan is chair of the Task Force on the Future of Health Insurance for Working Americans, a nonpartisan effort of the Commonwealth Fund to address the impli- cations of the changing U.S. work force and economy for the availability and affordability of health insurance, and is a member of the Kaiser Family Foundation Board and the Kaiser Commission on the Underserved and the Uninsured. Cynthia D. Mulrow, M.D., M.Sc.,* is clinical professor of medicine at the University of Texas Health Science Center at San Antonio, program director of the Robert Wood Johnson Foundation’s Generalist Physician Faculty Scholars Program, and Deputy Editor of Annals of Internal Medicine. Dr. Mulrow’s editorial board memberships and positions have included the editorial board of the British Medical Journal, the American Journal of Medicine, and the ACP Journal Club and the Clinical Advisory and Editorial Board (electronic and print Evidence-Based Thera- peutics Compendium). Dr. Mulrow’s expertise in clinical methodology, informa- tion synthesis, and systematic reviews also has resulted in invitations to serve on many national and international committees and task forces, including the Na- tional Advisory Committee of the Robert Wood Johnson Foundation’s Generalist Physician Faculty Scholars Program, the U.S. Preventive Services Task Force, and the Veterans Administration’s National Research and Methodology Committee. Christopher Queram, M.A., has been CEO of the Employer Health Care Alliance Cooperative (The Alliance) of Madison, Wisconsin, since 1993. The Alliance is a purchasing cooperative owned by more than 175 member companies that contracts with providers, manages and reports data, performs consumer edu- cation, and designs employer and provider quality initiatives. Prior to his current position, Mr. Queram served as vice president for programs at Meriter Hospital, a 475-bed hospital in Madison. Mr. Queram is a member of the Board of the National Business Coalition on Health and served as board chair for the past two years. He was a member of the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Mr. Queram served as a member of the Planning Committee for the National Quality Forum and contin- ues as convenor of the Purchaser Council of the Forum. He is a member of the Wisconsin Board on Health Information and the Board of the Wisconsin Private Employer Health Care Coverage program. He holds a master’s degree in health services administration from the University of Wisconsin at Madison and is a fellow in the American College of Healthcare Executives. Shoshanna Sofaer, Dr.P.H., is the Robert P. Luciano Professor of Health Care *Member of the Subcommittee on the Health Outcomes of the Uninsured.

APPENDIX E 173 Policy at the School of Public Affairs, Baruch College, in New York City. She completed her master’s and doctoral degrees in public health at the University of California, Berkeley; taught for six years at the University of California, Los Angeles, School of Public Health; and served on the faculty of George Washing- ton University Medical Center, where she was professor and associate dean for research of the School of Public Health and Health Services, and director of the Center for Health Outcomes Improvement Research. Dr. Sofaer’s research inter- ests include providing information to individual consumers on the performance of the health care system; assessing the impact of information on both consumers and the system; developing consumer-relevant performance measures; and improving the responsiveness of the Medicare program to the needs of current and future cohorts of older persons and persons with disabilities. In addition, Dr. Sofaer studies the role of community coalitions in pursuing public health and health care system reform objectives and has extensive experience in the evaluation of com- munity health improvement interventions. She has studied the determinants of health insurance status among the near-elderly, including early retirees. Dr. Sofaer served as Co-Chair of the Working Group on Coverage for Low Income and Non-Working Families for the White House Task Force on Health Care Reform in 1993. Currently, she is co-chair of the Task Force on Medicare of the Century Foundation in New York City, a member of the Board of Health Care Services, IOM, and a member of the AHRQ Health Systems Study Section. Stephen J. Trejo, Ph.D., is associate professor in the Department of Economics at the University of Texas at Austin. His primary research focus has been in the field of labor economics. He has examined the response of labor market partici- pants to incentives created by market opportunities, government policies, and the institutional environment. Specific research topics include the economic effects of overtime pay regulation; immigrant labor market outcomes and welfare recipiency; the impact of labor unions on compensation, employment, and work schedules; the importance of sector-specific skills; and the relative economic status of Mexi- can Americans. Reed V. Tuckson, M.D., is senior vice president of consumer health and medical care enhancement at United Health Group. Formerly, he was senior vice president, professional standards at the American Medical Association. Dr. Tuckson was president of Charles R. Drew University, School of Medicine and Science from 1991 to 1997. From 1986 to 1990, he was commissioner of public health for the District of Columbia. Dr. Tuckson serves on a number of health care, aca- demic, and federal boards and committees and is a nationally known lecturer on topics concerning community-based medicine, the moral responsibilities of health professionals, and physician leadership. He currently serves on the IOM Roundtable on Research and Development of Drugs, Biologics, and Medical Devices and is a member of the IOM.

174 CARE WITHOUT COVERAGE: TOO LITTLE, TOO LATE Edward H. Wagner, M.D., M.P.H., F.A.C.P.,* is a general internist–epide- miologist and director of the W.A. MacColl Institute for Healthcare Innovation at the Center for Health Studies, Group Health Cooperative of Puget Sound. He is also professor of health services at the University of Washington School of Public Health and Community Medicine. Current research interests include develop- ment and testing of population-based care models for diabetes, frail elderly, and chronic illnesses; evaluation of the health and cost impacts of chronic disease and cancer interventions; and interventions to prevent disability and reduce depressive symptoms in older adults. Dr. Wagner has written two books and more than 200 journal articles. He serves on the editorial boards of Health Services Research and the Journal of Clinical Epidemiology, and acts as a consultant to multiple federal agencies and private foundations. He recently completed a stint as senior advisor on man- aged care initiatives in the Director’s Office of the National Institutes of Health. As of June 1998, he directs Improving Chronic Illness Care (ICIC), a national program of the Robert Wood Johnson Foundation. The overall goal of ICIC is to assist health systems improve their care of chronic illness through quality improve- ment and evaluation, research, and dissemination. Dr. Wagner is also principal investigator of the Cancer Research Network, a National Cancer Institute funded consortium of 10 health maintenance organizations (HMOs) conducting collabo- rative cancer effectiveness research. Lawrence Wallack, Dr.P.H., is professor of public health and director, School of Community Health at Portland State University. He is also Professor Emeritus of Public Health, University of California, Berkeley. Dr. Wallack’s primary inter- est is in the role of mass communication, particularly the news media, in shaping public health issues. His current research is on how public health issues are framed in print and broadcast news. He is principal author of Media Advocacy and Public Health: Power for Prevention and News for a Change: An Advocate’s Guide to Working with the Media. He is also co-editor of Mass Communications and Public Health: Complexities and Conflicts. Dr. Wallack has published extensively on topics related to prevention, health promotion, and community interventions. Specific content areas of his research and intervention work have included alcohol, tobacco, vio- lence, handguns, sexually transmitted diseases, cervical and breast cancer, affirma- tive action, suicide, and childhood lead poisoning. Dr. Wallack is a member of the IOM Committee on Communication for Behavior Change in the 21st Century: Improving the Health of Diverse Populations. Robin M. Weinick, Ph.D.,* is director of intramural research in the Center for Primary Care Research at the Agency for Healthcare Research and Quality. Dr. Weinick led AHRQ’s efforts to build research agendas addressing the health care needs of low-income Americans and those residing in urban areas, and led an *Member of the Subcommittee on the Health Outcomes of the Uninsured.

APPENDIX E 175 interagency effort to develop a data system for monitoring the status of the health care safety net. She was actively involved with the Medical Expenditure Panel Survey project through various phases of the survey process, including question- naire design, pretesting, interviewer training, data editing, and data release activi- ties. Dr. Weinick has served as chairperson of several analytic groups contributing to different areas of survey content and data preparation, particularly access to care, health status and conditions, and demographics. Her research focuses on the relationship between families and health, as well as on access to care and popula- tions at risk of not having adequate access to and use of health care services, with particular emphasis on racial and ethnic disparities, children, and the impact of managed care gatekeeping. Institute of Medicine Staff Wilhelmine Miller, M.S., Ph.D., is a senior program officer in the Division of Health Care Services. She served as staff to the Committee on Immunization Finance Policy and Practices, conducting and directing case studies of health care financing and public health services. Prior to joining IOM, Dr. Miller was an adjunct faculty member in the Departments of Philosophy at Georgetown Uni- versity and Trinity College, teaching political philosophy, ethics, and public policy. She received her doctorate from Georgetown, with studies and research in bioet- hics and issues of social justice. In 1994–1995, Dr. Miller was a consultant to the President’s Advisory Committee on Human Radiation Experiments. Dr. Miller was a program analyst in the DHHS for 14 years, responsible for policy develop- ment and regulatory review in areas including hospital and HMO payment, pre- scription drug benefits, and child health. Her M.S. from Harvard University is in health policy and management. Dianne Miller Wolman, M.G.A., joined the Health Care Services Division of the Institute of Medicine in 1999 as a senior program officer. She directed the study that resulted in the IOM report Medicare Laboratory Payment Policy: Now and in the Future, released in 2000. Her previous work experience in the health field has been varied and extensive, focused on finance and reimbursement in insurance programs. She came from the General Accounting Office, where she was a senior evaluator on studies of the Health Care Financing Administration, its management capacity, and its oversight of Medicare contractors. Prior to that, she was a reim- bursement policy specialist at a national association representing nonprofit provid- ers of long-term care services. Her earlier positions included policy analysis and management in the office of the secretary in the DHHS, and work with a peer review organization, a governor’s task force on access to health care, and a third- party administrator for very large health plans. In addition, she was policy director for a state Medicaid rate setting commission. She has a master’s degree in govern- ment administration from Wharton Graduate School, University of Pennsylvania.

176 CARE WITHOUT COVERAGE: TOO LITTLE, TOO LATE Lynne Page Snyder, Ph.D., M.P.H., is a program officer in the IOM Division of Health Care Services. She came to IOM from DHHS, where she worked as a public historian, documenting and writing about past federal activities in medi- cine, health care, and public health. In addition, she has worked for the Social Science Research Council’s Committee on the Urban Underclass and served as a graduate fellow at the Smithsonian Institution’s National Museum of American History. She has published on twentieth century health policy, occupational and environmental health, and minority health. Current research interests include health literacy and access to care by low-income seniors. She earned her doctorate in the history and sociology of science from the University of Pennsylvania (1994), working under Rosemary Stevens, and received her M.P.H. from the Johns Hopkins School of Hygiene and Public Health (2000). Tracy McKay, B.A., is a research associate in the IOM Division of Health Care Services. She has worked on several projects, including the National Roundtable on Health Care Quality; Children, Health Insurance, and Access to Care; Quality of Health Care in America; and a study on non-heart-beating organ donors. She has assisted in the research for The National Quality Report on Health Care Delivery, Immunization Finance Policies and Practices, and Extending Medicare Coverage for Preventive and Other Services and helped develop this project on the consequences of uninsurance from its inception. Ms. McKay received her B.A. in sociology from Vassar College in 1996. Ryan Palugod, B.S., is a senior program assistant in the IOM Division of Health Care Services. Prior to joining the project staff in 2001, he worked as an admin- istrative assistant with the American Association of Homes and Services for the Aging. He graduated with honors from Towson University with a degree in health care management in 1999. Consultant to the Committee on the Consequences of Uninsurance Jennifer S. Haas, M.D., M.P.H., is assistant professor of medicine and re- searcher in the Institute for Health Policy Studies, University of California, San Francisco. Dr. Haas is an attending physician in the General Medical Clinic. Her research interests include women’s health, evaluation of the quality of medical care, access to medical care, and the health impacts both of health insurance and of socioeconomic status and race and ethnicity. She is affiliated with the Medical Effectiveness Research Center at UCSF and the Institute for Health Policy Stud- ies. She graduated from Harvard Medical School, completed residency training in primary care medicine in the Department of General Internal Medicine at San Francisco General Hospital, and received an M.P.H. from the Harvard School of Public Health.

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital--based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million -- one in seven--working--age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

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