Health insurance, the uninsured, and hospitals: collision course.

The number of uninsured Americans is approaching 50 million, with little evidence that the situation will improve any time soon. Although the consequences of this are serious in many ways, the implications for hospitals are especially severe, as they are the providers of care of last resort. Among the most serious problems for hospitals that treat uninsured patients are financial losses; difficulties in planning and in allocating resources; the need to make painful choices; litigation, both public and private; loss of community faith; the possible closing of needed institutions; and a perception of moral failure. The question is whether American hospitals have the will and the ability to stave off an impending disaster.