about our system as we try to address the significant concerns that certainly exist. in the remainder of my remarks, i will discuss three key challenges for health - care reform. these challenges are, in short, the issues of access, quality, and cost. challenges for health - care reform access access to health care is the first major challenge that health - care reform must address. in 2006, a total of 47 million americans, or almost 16 percent of the population, lacked health insurance. although the federal and state governments spent more than $ 35 billion to finance uncompensated care in 2004, the evidence nonetheless indicates that uninsured persons congressional budget office ( 2007 ). ibid. receive less health care than those who are insured and that their health suffers as a consequence. per capita expenditures on health care for uninsured individuals are, on average, roughly half those for fully insured individuals. 3 people who are uninsured are less likely to receive preventive and screening services, less likely to receive appropriate care to manage chronic illnesses, and more likely to die prematurely from cancer – largely because they tend to be diagnosed when the disease is more advanced. 4 one recent study found that uninsured victims of automobile accidents receive 20 percent less treatment in hospitals and are 37 percent more likely to die of their injuries than those who are insured. 5 quality the second key challenge is improving the quality of health care. the quality of medical research, training, and technology in the united states is generally very high. however, the quality of health care is determined not only by, say, technological advances in preventing and treating disease but also by our ability to deliver the benefits of those advances to patients. for maximum impact, advances in medical knowledge must be widely disseminated and consistently and efficiently implemented. but evidence suggests a disturbing gap between the quality of health services that can be provided in principle and the quality of health services that actually are provided in practice. for example, in 2000, the institute of medicine issued a landmark report that concluded that up to 98, 000 americans died each year in hospitals as a result of medical errors. 6 many of the errors identified by the report – for example, errors caused by adverse drug events, improper transfusions, wrong - site surgery, and mistaken patient identity – could have been prevented if hospitals had adopted appropriate safety systems. although hospitals have implemented a number of new safety practices since the time of that report, the scope for improving patient safety remains

caused equity prices to fall sharply, the cost of short - term credit – where available – to spike upward, and liquidity to dry up in many markets. losses at a large money market mutual fund sparked extensive withdrawals from a number of such funds. a marked increase in the demand for safe assets – a flight to quality – sent the yield on treasury bills down to a few hundredths of a percent. by further reducing asset values and potentially restricting the flow of credit to households and businesses, these developments pose a direct threat to economic growth. the federal reserve took a number of actions to increase liquidity and stabilize markets. notably, to address dollar funding pressures worldwide, we announced a significant expansion of reciprocal currency arrangements with foreign central banks, including an approximate doubling of the existing swap lines with the european central bank and the swiss national bank and the authorization of new swap facilities with the bank of japan, the bank of england, and the bank of canada. we will continue to work closely with colleagues at other central banks to address ongoing liquidity pressures. the federal reserve also announced initiatives to assist money market mutual funds facing heavy redemptions and to increase liquidity in short - term credit markets. despite the efforts of the federal reserve, the treasury, and other agencies, global financial markets remain under extraordinary stress. action by the congress is urgently required to stabilize the situation and avert what otherwise could be very serious consequences for our financial markets and for our economy. in this regard, the federal reserve supports the treasury's proposal to buy illiquid assets from financial institutions. purchasing impaired assets will create liquidity and promote price discovery in the markets for these assets, while reducing investor uncertainty about the current value and prospects of financial institutions. more generally, removing these assets from institutions ’ balance sheets will help to restore confidence in our financial markets and enable banks and other institutions to raise capital and to expand credit to support economic growth. at this juncture, in light of the fast - moving developments in financial markets, it is essential to deal with the crisis at hand. certainly, the shortcomings and weaknesses of our financial markets and regulatory system must be addressed if we are to avoid a repetition of what has transpired in our financial markets over the past year. however, the development of a comprehensive proposal for reform would require careful and extensive analysis that would be difficult to compress into a short legislative timeframe now available. looking forward, the federal reserve is committed to working closely with the congress, the administration