HHS Strategic Goals and Objectives - FY 2001 . Goal 3 - Improve Access to Health Services and Ensure the Integrity of the Nation's Health Entitlement and Safety Net Programs


In addition to changing behavior and reducing environmental health risks, improving health in the United States involves assuring that everyone has access to health care. The focus of Goal 3 is to promote increased access to health care, especially for persons who are uninsured, underserved, or otherwise have health care needs that are not adequately addressed by the private health care system.

The access challenges are substantial, particularly for some groups. Overall, approximately 45 million Americans lack health insurance. Although recent efforts to cover the nation's children are beginning to show success, many children still lack coverage. Over 2,000 counties in the United States are designated health profession shortage areas where access to primary health care for 45 million residents would be limited without HHS community programs. A 1998 Harvard School of Public Health/CDC study found that the lowest life expectancies in the country (including inner city ghettos) for both men and women exist in American Indian communities, and mortality disparities for American Indian/Native American people are worsening. Access to treatment for persons with HIV/AIDS, estimated to cost as much as $20,000 per year, would be severely limited without support for the cost of drug therapies and associated services. Less than one-third of the adults with diagnosable mental disorders receive treatment in a given year. Many families cannot afford the cost of care for children with special health care needs.

Minorities have particular problems with access and they face a range of disparities in health care. Approximately 38 percent of Hispanic and 24 percent of African-American adults are without health insurance, compared with 14 percent of white adults. Infant mortality rates are higher for minority groups, as are the incidence of illness and deaths associated with certain chronic diseases such as cancer, cardiovascular disease, and diabetes.

The major source of health insurance coverage for older Americans is Medicare. Ensuring the fiscal integrity of the program is critical to continued access to care. Significant accomplishments in reducing the financial drain from fraud, waste, and abuse have been recorded. Still, we can do more to reduce improper payments, which in fiscal year 1999 were estimated at $13.5 billion.

In addition to Medicare, the Department addresses the access challenge through a variety of entitlement and safety net programs, such as Medicaid, the State Children's Health Insurance Program, and Community Health Centers, that provide access to health care for uninsured and low income individuals.