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Brady G. S. Case, AB, David U. Himmelstein, MD and Steffie Woolhandler, MD, MPH

Brady G. S. Case is a medical student at Harvard Medical School, Boston, Mass. David U. Himmelstein and Steffie Woolhandler are with the Department of Medicine, The Cambridge Hospital/Harvard Medical School, Cambridge, Mass.

Correspondence: Requests for reprints should be sent to Brady G. S. Case, AB, 955 Massachusetts Ave, PMB #321, Cambridge, MA 02139 (e-mail: bcase{at}post.harvard.edu).

Objectives. This study examined trends in health insurance coverage for health care workers and their children between 1988 and 1998.

Methods. We analyzed data from the annual March supplements of the Current Population Survey (CPS), a Census Bureau survey that collects information about health insurance from a nationally representative sample of noninstitutionalized US residents.

Results. Of the health care personnel younger than 65 years, 1.36 million (90% confidence interval [CI] = 1.28 million, 1.45 million) were uninsured in 1998, up 83.4% from 1988; the proportion uninsured rose from 8.4% (90% CI = 7.8%, 9.1%) to 12.2% (90% CI = 11.5%, 12.9%). Declining coverage rates in the growing private-sector health care workforce—and declining health employment in the public sector, which provided health insurance benefits to more of its workers—accounted for the increases. Households with a health care worker included 1.12 million (90% CI = 1.05 million, 1.20 million) uninsured children, accounting for 10.1% (90% CI = 9.5%, 10.8%) of all uninsured children in the United States.

Conclusions. Health care personnel are losing health insurance coverage more rapidly than are other workers. Increasingly, the health care sector is consigning its own workers and their children to the ranks of the uninsured.

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