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The problems of uninsured are much broader than we think. More than one-sixth of a typical insured family pays directly or indirectly of its income for health care. This expensive care is far less effective than it should be. If they get to little preventive care, only 55 percent of proven effective therapies are administered when they get sick. Many major medical procedures are either inappropriate or low value. Reducing the number of the uninsured will medically be more effective and affordable. To address fully the problems of affordability and effectiveness is impossible. To eliminate these uncompensated cost shifts by insuring everyone would enable the health system to function better and reducing the fragmentation of financing and expanding risk pooling.