Yawn B P, Krein S
University of Minnesota Rural Health Research Center, USA.
Minn Med. 1997 Apr;80(4):42-9.
Many rural Americans remain underserved and uninsured. Attempts to initiate national health care reform and universal health insurance coverage have stalled. The impetus to continue reform and universal coverage efforts has shifted back to the state level. Minnesota's health reform efforts resulted in the 1992 MinnesotaCare legislation, which included a subsidized insurance program. As of October 21, 1995, a total of 91,140 people were enrolled in MinnesotaCare. Enrollees are found in every county in the state and represent approximately 2.1% of Minnesota's total population and 2.4% of the state's population under age 65. Estimates of Minnesotans who are uninsured and therefore potentially eligible for this subsidized insurance plan range from 6% to 13%. MinnesotaCare enrollment estimates vary from a high of 10.8% of Red Lake County's population who are under age 65 and report incomes over 100% of the poverty level to a low of 1.5% for similar residents of Nicollet County. Counties with the lowest percentage of MinnesotaCare enrollees are clustered in southern Minnesota, especially the southeastern counties. Those with the highest percentage of enrollees appear to cluster in central Minnesota. MinnesotaCare enrollment is negatively associated with the size of the county's minority population and population density.
许多美国农村地区居民仍然得不到充分的医疗服务，也没有医疗保险。发起全国医疗保健改革和全民医疗保险覆盖的努力陷入了停滞。继续推进改革和全民覆盖的动力已转回州一级。明尼苏达州的医疗改革努力促成了1992年的《明尼苏达保健法》，其中包括一项补贴保险计划。截至1995年10月21日，共有91140人加入了明尼苏达保健计划。该州每个县都有参保者，约占明尼苏达州总人口的2.1%，占该州65岁以下人口的2.4%。据估计，明尼苏达州未参保因而可能符合这项补贴保险计划资格的人数比例在6%至13%之间。明尼苏达保健计划的参保率估计各不相同，从红湖县65岁以下且报告收入超过贫困线100%的人口中的10.8%的高比例，到尼科莱特县类似居民中的1.5%的低比例。明尼苏达保健计划参保者比例最低的县集中在明尼苏达州南部，尤其是东南部的县。参保者比例最高的县似乎集中在明尼苏达州中部。明尼苏达保健计划的参保情况与该县少数族裔人口规模和人口密度呈负相关。
