Household Income—And Health Outcomes

By Martin Brown

healthcare crisis in AmericaWhen it comes to the healthcare crisis in America, we all suffer in one form or another.

America’s single women take a particularly hard and sometimes lethal hit by the inaccessibility of preventative healthcare measures and the rising cost of health care in the United States.

It’s astounding to think that the US spends more of its gross national product on healthcare than any other major industrialized nation in the world. And yet, for all those hundred of billions of dollars we have worse health outcomes than Japan, the United Kingdom, France, Germany, the Netherlands, Sweden, and many more.

As the health outcomes of Americans grow worse, the cost of medical services rise faster than the price of oil. The situation is that of a runaway train, and the results are not likely to be any less disastrous. Unfortunately, the outgoing Bush administration along with the legislative branch is reluctant to jump into the cab and take hold of the controls.

Reluctant? Perhaps it is simply lacking public consensus, or political will.

Meanwhile the crisis continues to build, impacting the insured and the uninsured in a variety of ways that continue to put access to quality healthcare out of the reach of a growing number of Americans.

Uninsured women (the majority of which are single) face a similar set of issues to single men, in addition to problems that are unique to women. Taken together, it’s a potentially lethal combination.

Consider the following facts, cited in a 2007 report from the Office on Women’s Health in the U.S. Department of Health and Human Service—and note how many of these findings draw similar conclusions:

“Uninsured women are the least likely to have had a provider visit in the past year (67%), compared to women with either private (90%) or public insurance-Medicaid (88%) and Medicare (93%)…” (Salganicoff 2005).

“When women are uninsured, they are more likely to postpone care and to forgo filling prescriptions than their insured counterparts and often delay or go without important preventive care such as mammograms and Pap tests…” (Henry J. Kaiser Family Foundation, 2006).

“Women without insurance consistently report lower use of preventive services, more difficulty paying for care and medicines, and greater barriers to obtaining services…” (Salganicoff 2005).

“Women without insurance consistently fare worse on multiple measures of access to care, including contact with providers, obtaining timely care, access to specialists, and utilization of important screening tests…” (Salganicoff 2005).

“Studies have shown that uninsured women have difficulty accessing care; go without needed care; are less likely to fill a recommended prescriptions; do not receive preventive care services such as clinical breast exam, mammogram, or Pap test; do not have a regular source of care; and are more likely to rely on episodic emergency room or clinic care…” (Kasper, 2004).

“Uninsured women faced larger access barriers and utilized fewer services, particularly preventive care services, than women with either public or private coverage…” (Almeida, Dubay, & Ko, 2001)

“Uninsured women face significant barriers to care not met by the current safety net system, especially medical, surgical, and dental services…” (Almeida 2001).

It is important to note that while not having insurance is associated with poor quality of care, access alone does not guarantee quality:

“Although having insurance increases the ease of access to the health care system, it is not sufficient to ensure appropriate use of services or content of care. Indeed, within systems where access to care is more equitable, disparities in quality due to race or ethnic group or to other characteristics are often reduced or even reversed, but substantial gaps between observed and optimal quality remain…” (Asch, 2006)

Also, for those who do have coverage the combination of policy payments, service co-pays, and care deductibles grows increasingly less affordable each year.

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