The uninsured and the financing of uncompensated care: scope, costs, and policy options.

Access to health care services for the poor and uninsured and financing hospital bad debt and charity care costs encompass two separate and different sets of public policy concerns. However, the two are increasingly considered together by policy makers concerned that future marketplace pressures will challenge hospitals' willingness and ability to provide free care to the poor. This paper explores this presumption, looking at the characteristics and the magnitude of the uninsured population, the cost of bad debt and charity care, and the distribution of those costs among hospitals and among third-party payers. Four broad policy approaches directed at assuring access to care are raised, and the strengths and weaknesses of each approach are discussed.