Posted by & filed under Noah's Notes.

Although America’s health care system is often touted as “the best in the world” that is demonstrably untrue. A recent study published in Health Affairs magazine, however, indicates that we are a world leaders in one area of healthcare: inequality.

The difference between rich and poor as it pertains to access to care and health outcomes is dramatic in the US, and is among the most stark in the entire world.  In fact, in comparing 32 rich and middle class countries only Chile and Portugal were worse.  Some findings from the study, between 2011 and 2013:

  • 38% of people in households making less than $22,500 a year reported being in poor or fair health.
  • 12% of people in households making more than $47,700 a year reported being in poor or fair health.
  • 1 in 5 people in the lower 1/3 of income earners skipped medical treatments due to cost (only the Phillipines was worse than the US).
  • 1 in 25 people in the upper 1/3 of income earners skipped medical treatments due to cost.

Most alarmingly to me, 2/3 of Americans are aware that there are many Americans who do not have access to needed care, but only 54% of people believe that this disparity is unfair.  That indicates a very significant apathy toward the plight of the less fortunate in this country, and may reflect the US approach of attaching health care coverage to employment, and our bias about the unemployed or underpaid.

It’s important to note that this study was conducted before many of the Affordable Care Act policies were implemented, and US studies after that implementation indicated some promising trends, especially in states where Medicaid was expanded.  However, The American Health Care Act, proposed by Congress, would result in 23 million people in the US and 117,000 in Maine losing healthcare coverage and would remove many of the policies which expanded access to care.  That is certain to worsen disparities between the rich and poor.  The question is, does that matter to the American people?

Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

Leave a Reply

Your email address will not be published. Required fields are marked *