for certain populations. It might seem that such positive changes as advances in medical science and technology, would generally make medical care more accessible. But the statistics do not bear that out. In 1992, when the decadeÆs debate on health care and the public discourse about national health insurance began in earnest, the number of medically uninsured Americans was said to be 37 million; by 1998, that figure was 43 million (Bavley & Sanchez, 1998). The working poor who cannot afford to buy medical insurance yet cannot qualify for publicly funded health care are part of this universe. Approximately six million workers--typically younger, racial-minority, and/or lower-wage employees--refuse employment-related health insurance even when available, owing to such reasons as increases in employee contributions to plans vis-a-vis real-wage decline and legislation meant to enhance insurance coverage that, ironically, increased costs, as care providers seized the opportunity to obtain a slice of the legislative increase (Cooper & Schone, 1997).
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