Beyond the uninsured: problems in access to care.

This paper investigates the difficulties that people encounter in their attempt to obtain needed health services, other than their third-party coverage or lack of it. These problems can be temporal, geographic, attitudinal, or financial (even with insurance). A state-wide sample survey conducted in 1989 revealed that about 17% of Michigan's population experienced one or more of these kinds of difficulties in their attempts to receive medical care. Those at greater risk included persons with public insurance coverage (mostly Medicaid), persons with low incomes, persons in poor health, women, and members of some ethnic minority groups. The findings suggest that addressing the problem of access to care through an exclusive focus on the uninsured, especially through public programs, could leave significant residual problems for several segments in American society.