There are several issues regarding the uninsured and underinsured patient population in America. There are many areas of concern: Congressional efforts to increase the availability of health insurance, the public image of the insurance industry illustrated by the movie "John Q," the lack of good management tools and the creation of health insurance coverage for all low-income Americans. . As the number of uninsured Americans has risen to 43 million from 37 million in the booming 1990s, it could rise even more severely if the economy continues to decline and health care premiums continue to rise (Insurance No Simple Fix, 2001). understand the uninsured and underinsured problem facing hospital administrators, the cause must be examined. The health outcomes of uninsured individuals are generally worse than those with insurance. Uninsured people are more likely to experience avoidable hospitalizations, be diagnosed in advanced stages of the disease, hospitalized in emergencies or emergencies, and become more seriously ill after hospitalization (Simpson, 2002). Because the uninsured often do not have an ongoing relationship with a health care provider, they are less likely to receive preventive care and diagnostic testing (Kemper, 2002). Many companies manage to balance their budgets through cost cuts and other measures, but find themselves burdened by a growing burden of uninsured patients, along with reduced payments from public and private insurance programs. In 2000, 564,476 uninsured patients passed through Health and Hospitals Corporation health centers, a 30 percent increase over 1996. Over the same period, Congress reduced Medicare reimbursements to hospitals and reduced Medicaid reimbursements to assisted living clinics. primary have remained basic. middle of paper ......ter drugs in Mexico that are only prescription in the U.S. In Massachusetts, uninsured college students often know people who know doctors who are able to write them prescriptions or give out drug samples for free without examining the patient. Furthermore, uninsured Americans do not fill their prescriptions, save them for future use, and do not even share them with friends and relatives (Sered & Fernandopulle 2005). Health insurance and health outcomes are closely associated. However, if the same uninsured individual has continuous health insurance, he or she will not be at risk of premature death and will have better health outcomes (Marwick 2002). Uninsured people report poorer health than people with health insurance. Low levels of self-reported health status are a powerful predictor of future disease and premature death (Bailey 2009).