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Carol Pryor

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And small increments increased the likelihood of problems.

The distinction between uninsured and insured isn't as simple as it used to be. When we look at people who are insured, we need to know not only if they have insurance, but do they have adequate insurance. So, the numbers could be misleadingly low.

The findings again call into question the whole approach of shifting more costs onto consumers with consumer-driven health care. If you look at a single mom with a kid at twice the poverty level and you look at the required deductible, it's already about 7.5 percent of income and that excludes the cost of the premium and other out-of-pocket costs.

There is a growing awareness at all levels of how broken our system is becoming. Health insurance is becoming increasingly unaffordable. The proposals that have dominated at the federal level are generally counterproductive, including health savings accounts.

These findings are clearly consistent with findings elsewhere. They point to a common problem.

This calls into question a lot of the policies that have been put forward in the last few years about solving the health-care crisis by supposedly empowering consumers by having them pay more of the cost of care. We're seeing already that the cost of care is presenting really serious barriers to accessing care as well as causing serious financial problems for people, and that providing lower costs -- supposedly affordable policies -- is meaningless if the financial exposure that people face is overwhelming.

This report does confirm and reinforce a lot of things that we know have been happening. One is that with insurance premiums continually going up at a rapid rate and coverage eroding, we're finding that even moderate- and middle-income families are starting to find insurance unaffordable, with the result that the number of uninsured in those groups is rising.

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