One-third of uninsured Americans have at least one chronic disease, according to a new report from the Annals of Internal Medicine, including asthma/COPD, diabetes, heart disease, and previous cancer. It refutes suggestions that the uninsured are mainly healthy people not much in need healthcare.

Latest stats are that 43 million Americans are without insurance. The nearly 11 and a half million with chronic diseases and no way to get healthcare are much more likely to “face early disability and death as a result.” But researchers say that insurance reform will not be sufficient. That because of budget issues, optimal care is not available even to many of those who have coverage. That if resources flow to organizations that serve many vulnerable patients and quality improvements are made, that alone can “improve outcomes for the uninsured.”