The growing number of uninsured Americans—totaling 45.7 million as of 2007—is taking a toll on the nation’s health. One in five adults under age 65 and nearly one in ten children are uninsured. Uninsured individuals experience much more risk to their health than insured individuals. In its 2009 report America’s Uninsured Crisis: Consequences for Health and Health Care, the Institute of Medicine points to a chasm between the health care needs of people without health insurance and ac­cess to effective health care services. This gap results in needless illness, suffering, and even death.

For decades, the health insurance crisis has grown without any decisive action by policy makers to stop it. Now is the time for action, say the report’s authors, recommending that the President work with Congress and other public and private sector leaders on an urgent basis to achieve health insurance coverage for everyone and, in order to make that coverage sus­tainable, to reduce the costs of health care and the rate of increase in health care spending.