Living on the edge: A phenomenological study of medically uninsured working Americans

An estimated 35 to 50 million Americans have no medical insurance; the vast majority are employed persons and their dependents. This phenomenological study was developed to make visible the experience of working Americans liv ing on the edge-forced to walk a fine line between health and illness witho ut the safety net of medical insurance. A purposive sample of 12 individual s was asked, "What is it like to be working and without medical insurance?" Based on textual analysis, using an adaptation of Colazzi's method, themes were grouped into four theme clusters: A Marginalized Life, Up Against Roc ks and Hard Places, Making Choices-Chancing It, and Getting By-More or Less . These are illustrated through commentary and direct quotation to depict a n overall sense of the experience. Implications for nurses charged with add ressing the needs of the medically uninsured and for nursing as a whole are discussed. (C) 2000 John Wiley & Sons, Inc.