In the unlikely event that President Obama needs to be reminded about the importance of health coverage before he gives his speech to the nation on the economy tonight or convenes his health summit next week, the prestigious Institute of Medicine has just issued a 200-page reminder.

Like the IoM's earlier reports, the new document, "America's Uninsured Crisis: Consequences for Health and Health Care", concludes that for the 46 million people who lack insurance, it's more than an economic challenge. Being uninsured is hazardous to people's health. In fact, spillover effects from high uninsurance rates even seem to be hazardous to a whole community's health.

The nonpartisan, influential IoM's panel pointed out that "a number of ominous signs" tell us to brace for continuing decline in health coverage, as costs and insurance premiums rise while the economy weakens. Fewer people can expect health benefits on the job (if they have a job) or as part of their retirement benefits. Policies on the private insurance market are "prohibitively expensive or unavailable."

And coverage matters:

A robust body of well-designed, high-quality research provides compelling find­ings about the harms of being uninsured and the benefits of gaining health insurance for both children and adults. Despite the availability of some safety net services, there is a chasm between the health care needs of people without health insurance and ac­cess to effective health care services. This gap results in needless illness, suffering, and even death.

For a host of diseases and conditions—stroke, cancer, congestive heart failure, diabetes, heart attacks and hypertension to name a few—people are likely to have worse outcomes if they lack insurance. Even adult car crash victims who are uninsured "have a substantially higher mortality rates" than insured adults. In other words, they are more likely to die.

The committee stresses that there is no more time to waste:

The committee recommends that the President work with Congress and other public and private sector leaders on an urgent basis to achieve health insurance coverage for everyone and, in order to make that coverage sustainable, to reduce the costs of health care and the rate of increase in per capita health care spending.

The panel is crystal clear about the priorities. Work on the cost and sustainability challenges, work on them hard and quickly but don't put off covering all Americans while we wait for the cost issues to be solved. They write, "The committee does not believe that action should be delayed pending the development of a long-term solution to curbing underlying health care costs. Given the demonstrated harms of not having health insurance for children and adults, the committee believes that action to achieve coverage for all should proceed immediately."